Growing Up in Singapore Towards Healthy Outcomes (GUSTO)

• ClinicalTrials.gov Identifier: NCT01174875
• Recruitment Status: Active, not recruiting
• First Posted: August 4, 2010
• Last Update Posted: January 23, 2023
• Sponsor: National University Hospital, Singapore
• Collaborators: KK Women's and Children's Hospital; Singapore Institute for Clinical Sciences
• Information provided by (Responsible Party): National University Hospital, Singapore

Study Description

Brief Summary:

This study aims to test the following hypotheses in women recruited in early pregnancy and whose children will be followed up till at least 14 years of age.

• Epigenetic changes in conceptual tissues obtained at birth reflect the environment that the fetus was exposed to during development.
• The pattern of epigenetic marks in gene promoters obtained from DNA in birth tissues, together with genotype, phenotype, and environmental exposures, can be utilized to assess how the perinatal environment affects subsequent metabolic, neurodevelopmental and other phenotypes.

Condition or disease
Metabolic Diseases; Neurological and Mental Health Conditions

Detailed Description:

The dramatic emergence of non-communicable diseases (NCDs) in Asia has coincided with the rapid socioeconomic and nutritional transition taking place in the region, with the prevalence of diabetes rising five-fold in Singapore in less than four decades. One unique aspect of the epidemic has been the significant ethnic differences in predisposition to diabetes among Asians and in the ethnic variation between BMI and the risk of developing insulin resistance, a precursor to type 2 diabetes. Apart from genetic factors, dietary, lifestyle and cultural factors might have influenced the developmental programming through effects on the mechanisms associated with developmental plasticity. A center piece of this study is to examine how epigenetic changes at birth both reflects past developmental influences and, in association with other factors, influences future trajectories of development and its relationship to NCDs. Also factors active during childhood - especially the first 1000 days of life - will be focused upon.

The longitudinal GUSTO birth cohort study allows us to examine associations among genetic, environmental and lifestyle interactions in the three distinct ethnic groups, Chinese, Malays and Indians, present in the Singaporean population.

Participants have been followed up for their pregnancy outcome, fetal growth and offspring development for over a decade. Participants will continue to be followed up as the children enter into the pubertal phase from the age of 10 to 14 years.

Data will be collected through questionnaires and clinical measurements. The questionnaires include socio-economic factors, maternal and child's diet, medical histories, behavioural, cognition, lifestyle factors, health status, and home environment. Bio-physical measurements will be obtained from anthropometric measurements of participants, human biological materials such as blood, buccal swabs, saliva, hair, urine, stool, oral specimen such as exfoliated milk teeth, dental plaque and tongue biofilms are collected from the participants (mother / father / child where applicable) at their follow-up time points with the GUSTO cohort upon their consent.

Study Design

• Study Type: Observational
• Actual Enrollment: 1247 participants
• Observational Model: Cohort
• Time Perspective: Prospective
• Official Title: Metabolic Health in Asian Women and Their Children
• Actual Study Start Date: June 2009
• Estimated Primary Completion Date: July 2029
• Estimated Study Completion Date: July 2029

Groups and Cohorts

Group/Cohort

Pregnant mothers, infants and children; Women in their early pregnancy who are attending the first trimester antenatal ultrasound scan at the public maternity units at KK Women's and Children's Hospital (KKH) and National University Hospital (NUH). Only women age 18 years and above who are Singapore Citizens or Singapore Permanent Residents. Participants have to intend to eventually deliver in NUH or KKH and to reside in Singapore for the next 5 years. Willingness to donate cord, cord blood and placenta. The fetus should be racially homogenous with both sets of grandparents of the same ethnicity. Babies born from these mothers will be followed up until the child is at least 14 years of age.

Outcome Measures

Primary Outcome Measures :

1. Roles of fetal, developmental and epigenetic factors in pathways to disease [ Time Frame: Perinatal ]
   To evaluate the role of fixed genetic risk variants, modifiable epigenetic markers, circulating metabolites and hormones in blood, and host-microbe interactions which can reflect past developmental influences, and in association with other factors, affect future trajectories of development and its relationship to NCDs.

Secondary Outcome Measures :

1. Influence of prenatal and early postnatal factors on child health [ Time Frame: During pregnancy and infancy period ]
   To examine the role of maternal nutrition, lifestyle, emotional health, and other environmental factors in infancy that can influence the development of phenotypes in childhood which confer risk for later metabolic and mental disorders.
2. Effect of factors in pregnancy and early postpartum period on maternal health [ Time Frame: During pregnancy and postpartum period ]
   To examine the role of maternal nutrition, lifestyle, emotional health, and other environmental factors in pregnancy or postpartum period that can influence future maternal risk of metabolic disorders, including body weight changes.
3. Influence genetic and epigenetics factors in combination with lifestyle on child health [ Time Frame: Childhood and Adolescence up to age 14 ]
   To examine the role of genetic and epigenetic factors, lifestyle (physical activity and dietary intake), growth trajectories and other environmental factors that can influence the development of phenotypes in childhood which confer risk for later metabolic and mental disorders.

Biospecimen Retention:   Samples With DNA

During pregnancy; Mother: blood, buccal and hair samples. At delivery; cord, cord blood and placenta. During infancy and childhood; Stool, nasal, buccal samples, saliva, urine, blood and exfoliated teeth from the children, breast milk from breastfeeding mothers

Eligibility Criteria

• Ages Eligible for Study: 18 Years to 50 Years (Adult)
• Sexes Eligible for Study: Female
• Accepts Healthy Volunteers: Yes
• Sampling Method: Non-Probability Sample

Study Population

Pregnant mothers who are attending the first trimester antenatal visit at the public maternity units in KKH and NUH.

Criteria

Inclusion Criteria:

• Women 18 years and above
• Pregnant women attending the first visit (< 14 weeks GA) at the maternity units of KKH and NUH
• Singapore citizens or Singapore Permanent Residents
• Currently resident in mainland Singapore
• Intention to eventually deliver in KKH or NUH
• Intention to reside in Singapore for the next 5 years
• Intention to donate cord, cord blood and placenta
• The fetus should be racially homogenous with both sets of grandparents of the same ethnicity

Exclusion Criteria:

• Women whose pregnancies end in miscarriages will be excluded
• Pregnant women on chemotherapy
• Exclude women with significant medical conditions e.g. Type 1 diabetes mellitus, psychosis etc.
• Exclude women on certain medications - e.g. psychotropic drugs.
• Mixed marriages will be excluded

Contacts and Locations

Locations

Singapore

National University Hospital

Singapore, Singapore

Sponsors and Collaborators

National University Hospital, Singapore

KK Women's and Children's Hospital

Singapore Institute for Clinical Sciences

Investigators

• Principal Investigator: Yap-Seng Chong; National University Health System

More Information

Additional Information:

Study website 

Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):

Mir SA, Chen L, Burugupalli S, Burla B, Ji S, Smith AAT, Narasimhan K, Ramasamy A, Tan KM, Huynh K, Giles C, Mei D, Wong G, Yap F, Tan KH, Collier F, Saffery R, Vuillermin P, Bendt AK, Burgner D, Ponsonby AL, Lee YS, Chong YS, Gluckman PD, Eriksson JG, Meikle PJ, Wenk MR, Karnani N. Population-based plasma lipidomics reveals developmental changes in metabolism and signatures of obesity risk: a mother-offspring cohort study. BMC Med. 2022 Jul 25;20(1):242. doi: 10.1186/s12916-022-02432-y.

Kumar M, Ang LT, Ho C, Soh SE, Tan KH, Chan JKY, Godfrey KM, Chan SY, Chong YS, Eriksson JG, Feng M, Karnani N. Machine Learning-Derived Prenatal Predictive Risk Model to Guide Intervention and Prevent the Progression of Gestational Diabetes Mellitus to Type 2 Diabetes: Prediction Model Development Study. JMIR Diabetes. 2022 Jul 5;7(3):e32366. doi: 10.2196/32366.

Loo EXL, Ooi DSQ, Ong M, Ta LDH, Lau HX, Tay MJY, Yap QV, Chan YH, Tham EH, Goh AEN, Van Bever H, Teoh OH, Eriksson JG, Chong YS, Gluckman P, Yap FKP, Karnani N, Xu J, Tan KML, Tan KH, Lee BW, Kramer M, Shek LP, Meaney MJ, Broekman BFP. Associations Between Eczema and Attention Deficit Hyperactivity Disorder Symptoms in Children. Front Pediatr. 2022 Mar 30;10:837741. doi: 10.3389/fped.2022.837741. eCollection 2022.

Chen L, Tan KML, Gong M, Chong MFF, Tan KH, Chong YS, Meaney MJ, Gluckman PD, Eriksson JG, Karnani N. Variability in newborn telomere length is explained by inheritance and intrauterine environment. BMC Med. 2022 Jan 25;20(1):20. doi: 10.1186/s12916-021-02217-9.

Wong BW, Toh JY, Sugianto R, Chia A, Tint MT, Yuan WL, Padmapriya N, Lanca C, Saw SM, Lee YS, Shek LP, Tan KH, Yap F, Godfrey KM, Chong YS, Muller-Riemenschneider F, Eriksson JG, Chan SY, Chong MF. Associations of Childcare Arrangements with Adiposity Measures in a Multi-Ethnic Asian Cohort: The GUSTO Study. Int J Environ Res Public Health. 2021 Nov 19;18(22):12178. doi: 10.3390/ijerph182212178.

Padmapriya N, Chen B, Goh CMJL, Shek LPC, Chong YS, Tan KH, Chan SY, Yap F, Godfrey KM, Lee YS, Eriksson JG, Bernard JY, Muller-Riemenschneider F. 24-hour movement behaviour profiles and their transition in children aged 5.5 and 8 years - findings from a prospective cohort study. Int J Behav Nutr Phys Act. 2021 Nov 6;18(1):145. doi: 10.1186/s12966-021-01210-y.

Lim IY, Lin X, Teh AL, Wu Y, Chen L, He M, Chan SY, MacIsaac JL, Chan JKY, Tan KH, Chong MFF, Kobor MS, Godfrey KM, Meaney MJ, Lee YS, Eriksson JG, Gluckman PD, Chong YS, Karnani N. Dichotomy in the Impact of Elevated Maternal Glucose Levels on Neonatal Epigenome. J Clin Endocrinol Metab. 2022 Feb 17;107(3):e1277-e1292. doi: 10.1210/clinem/dgab710.

Ong J, Sadananthan SA, Soh SE, Ng S, Yuan WL, Aris IM, Tint MT, Michael N, Loy SL, Tan KH, Godfrey KM, Shek LP, Yap F, Lee YS, Chong YS, Chan SY. Increasing nausea and vomiting of pregnancy is associated with sex-dependent differences in early childhood growth: the GUSTO mother-offspring cohort study. BMC Pregnancy Childbirth. 2021 Aug 22;21(1):578. doi: 10.1186/s12884-021-04024-9.

Pang WW, Geddes DT, Lai CT, Chan SY, Chan YH, Cheong CY, Fok D, Chua MC, Lim SB, Huang J, Pundir S, Tan KH, Yap F, Godfrey KM, Gluckman PD, Shek LP, Vickers MH, Eriksson JG, Chong YS, Wlodek ME. The association of maternal gestational hyperglycemia with breastfeeding duration and markers of milk production. Am J Clin Nutr. 2021 Sep 1;114(3):1219-1228. doi: 10.1093/ajcn/nqab142.

Loo EXL, Lau HX, Suaini NHA, Wong LSY, Goh AEN, Teoh OH, Van Bever HP, Shek LP, Lee BW, Tan KH, Godfrey KM, Eriksson JG, Chong YS, Tham EH. House dust mite sensitization, eczema, and wheeze increase risk of shellfish sensitization. Pediatr Allergy Immunol. 2021 Jul;32(5):1096-1099. doi: 10.1111/pai.13493. Epub 2021 Mar 20. No abstract available.

van Lee L, Chia A, Phua D, Colega M, Padmapriya N, Bernard JY, Cai S, Tham EKH, Teoh OH, Goh D, Gooley JJ, Gluckman PD, Yap F, Shek LPC, Godfrey KM, Tan KH, Chong YS, Muller-Riemenschneider F, Broekman B, Meaney M, Chen H, Chong MFF. Multiple modifiable lifestyle factors and the risk of perinatal depression during pregnancy: Findings from the GUSTO cohort. Compr Psychiatry. 2020 Nov;103:152210. doi: 10.1016/j.comppsych.2020.152210. Epub 2020 Sep 30.

Xu J, Lawley B, Wong G, Otal A, Chen L, Ying TJ, Lin X, Pang WW, Yap F, Chong YS, Gluckman PD, Lee YS, Chong MF, Tannock GW, Karnani N. Ethnic diversity in infant gut microbiota is apparent before the introduction of complementary diets. Gut Microbes. 2020 Sep 2;11(5):1362-1373. doi: 10.1080/19490976.2020.1756150. Epub 2020 May 26.

Tan CW, Sultana R, Kee MZL, Meaney MJ, Sng BL. Investigating the association between labour epidural analgesia and postpartum depression: A prospective cohort study. Eur J Anaesthesiol. 2020 Sep;37(9):796-802. doi: 10.1097/EJA.0000000000001236.

Tint MT, Sadananthan SA, Soh SE, Aris IM, Michael N, Tan KH, Shek LPC, Yap F, Gluckman PD, Chong YS, Godfrey KM, Velan SS, Chan SY, Eriksson JG, Fortier MV, Zhang C, Lee YS. Maternal glycemia during pregnancy and offspring abdominal adiposity measured by MRI in the neonatal period and preschool years: The Growing Up in Singapore Towards healthy Outcomes (GUSTO) prospective mother-offspring birth cohort study. Am J Clin Nutr. 2020 Jul 1;112(1):39-47. doi: 10.1093/ajcn/nqaa055.

Fogel A, McCrickerd K, Aris IM, Goh AT, Chong YS, Tan KH, Yap F, Shek LP, Meaney MJ, Broekman BFP, Godfrey KM, Chong MFF, Cai S, Pang WW, Yuan WL, Lee YS, Forde CG. Eating behaviors moderate the associations between risk factors in the first 1000 days and adiposity outcomes at 6 years of age. Am J Clin Nutr. 2020 May 1;111(5):997-1006. doi: 10.1093/ajcn/nqaa052.

Chen B, Bernard JY, Padmapriya N, Ning Y, Cai S, Lanca C, Tan KH, Yap F, Chong YS, Shek L, Godfrey KM, Saw SM, Chan SY, Eriksson JG, Tan CS, Muller-Riemenschneider F. Associations between early-life screen viewing and 24 hour movement behaviours: findings from a longitudinal birth cohort study. Lancet Child Adolesc Health. 2020 Mar;4(3):201-209. doi: 10.1016/S2352-4642(19)30424-9. Epub 2020 Jan 28.

Loo EXL, Zhu Y, Lai JS, Chan YH, Ong CN, Tham EH, Goh A, Teoh OH, Tan KH, Yap F, Chong YS, Gluckman PD, Godfrey KM, Van Bever H, Lee BW, Chong MF, Shek LP. Association between maternal carotenoid, vitamin A, and vitamin E levels and allergic outcomes in the offspring in the first 5 years of life. Pediatr Allergy Immunol. 2020 Jan;31(1):95-97. doi: 10.1111/pai.13122. Epub 2019 Oct 9. No abstract available.

Quah PL, Kleijweg J, Chang YY, Toh JY, Lim HX, Sugianto R, Aris IM, Yuan WL, Tint MT, Bernard JY, Natarajan P, Muller-Riemenschneider F, Godfrey KM, Gluckman PD, Chong YS, Shek LP, Tan KH, Eriksson JG, Yap F, Lee YS, Chong MFF. Association of sugar-sweetened beverage intake at 18 months and 5 years of age with adiposity outcomes at 6 years of age: the Singapore GUSTO mother-offspring cohort. Br J Nutr. 2019 Dec 14;122(11):1303-1312. doi: 10.1017/S0007114519002253.

Quah PL, Ng JC, Fries LR, Chan MJ, Aris IM, Lee YS, Yap F, Godfrey KM, Chong YS, Shek LP, Tan KH, Forde CG, Chong MFF. Longitudinal Analysis Between Maternal Feeding Practices and Body Mass Index (BMI): A Study in Asian Singaporean Preschoolers. Front Nutr. 2019 Apr 2;6:32. doi: 10.3389/fnut.2019.00032. eCollection 2019.

Loy SL, Lim LM, Chan SY, Tan PT, Chee YL, Quah PL, Chan JKY, Tan KH, Yap F, Godfrey KM, Shek LP, Chong MF, Kramer MS, Chong YS, Chi C. Iron status and risk factors of iron deficiency among pregnant women in Singapore: a cross-sectional study. BMC Public Health. 2019 Apr 11;19(1):397. doi: 10.1186/s12889-019-6736-y.

Wu Y, Lin X, Lim IY, Chen L, Teh AL, MacIsaac JL, Tan KH, Kobor MS, Chong YS, Gluckman PD, Karnani N. Analysis of two birth tissues provides new insights into the epigenetic landscape of neonates born preterm. Clin Epigenetics. 2019 Feb 11;11(1):26. doi: 10.1186/s13148-018-0599-4.

Sadananthan SA, Tint MT, Michael N, Aris IM, Loy SL, Lee KJ, Shek LP, Yap FKP, Tan KH, Godfrey KM, Leow MK, Lee YS, Kramer MS, Gluckman PD, Chong YS, Karnani N, Henry CJ, Fortier MV, Velan SS. Association Between Early Life Weight Gain and Abdominal Fat Partitioning at 4.5 Years is Sex, Ethnicity, and Age Dependent. Obesity (Silver Spring). 2019 Mar;27(3):470-478. doi: 10.1002/oby.22408. Epub 2019 Feb 1.

Loo EXL, Chew LJM, Zulkifli AB, Ta LDH, Kuo IC, Goh A, Teoh OH, Van Bever H, Gluckman PD, Yap F, Tan KH, Chong YS, Lee BW, Shek LP. Comparison of microbiota and allergen profile in house dust from homes of allergic and non-allergic subjects- results from the GUSTO study. World Allergy Organ J. 2018 Dec 5;11(1):37. doi: 10.1186/s40413-018-0212-5. eCollection 2018.

Tham EH, Tan PT, Loo EXL, Goh AEN, Teoh OH, Yap F, Tan KH, Godfrey KM, Van Bever HP, Lee BW, Finkelstein EA, Chong YS, Shek LP. Early childcare enrollment and childhood wheezing phenotypes. Pediatr Allergy Immunol. 2019 Feb;30(1):122-127. doi: 10.1111/pai.12983. Epub 2018 Dec 9. No abstract available.

Bernard JY, Pan H, Aris IM, Moreno-Betancur M, Soh SE, Yap F, Tan KH, Shek LP, Chong YS, Gluckman PD, Calder PC, Godfrey KM, Chong MF, Kramer MS, Karnani N, Lee YS. Long-chain polyunsaturated fatty acids, gestation duration, and birth size: a Mendelian randomization study using fatty acid desaturase variants. Am J Clin Nutr. 2018 Jul 1;108(1):92-100. doi: 10.1093/ajcn/nqy079.

Soh SE, Goh A, Teoh OH, Godfrey KM, Gluckman PD, Shek LP, Chong YS. Pregnancy Trimester-Specific Exposure to Ambient Air Pollution and Child Respiratory Health Outcomes in the First 2 Years of Life: Effect Modification by Maternal Pre-Pregnancy BMI. Int J Environ Res Public Health. 2018 May 15;15(5):996. doi: 10.3390/ijerph15050996.

Tham EH, Loo EXL, Goh A, Teoh OH, Yap F, Tan KH, Godfrey KM, Van Bever H, Lee BW, Chong YS, Shek LP. Phototherapy for neonatal hyperbilirubinemia and childhood eczema, rhinitis and wheeze. Pediatr Neonatol. 2019 Feb;60(1):28-34. doi: 10.1016/j.pedneo.2018.03.004. Epub 2018 Mar 24.

Fogel A, Mccrickerd K, Fries LR, Goh AT, Quah PL, Chan MJ, Toh JY, Chong YS, Tan KH, Yap F, Shek LP, Meaney MJ, Broekman BFP, Lee YS, Godfrey KM, Chong MFF, Forde CG. Eating in the absence of hunger: Stability over time and associations with eating behaviours and body composition in children. Physiol Behav. 2018 Aug 1;192:82-89. doi: 10.1016/j.physbeh.2018.03.033. Epub 2018 Mar 30.

Chi C, Loy SL, Chan SY, Choong C, Cai S, Soh SE, Tan KH, Yap F, Gluckman PD, Godfrey KM, Shek LP, Chan JKY, Kramer MS, Chong YS. Impact of adopting the 2013 World Health Organization criteria for diagnosis of gestational diabetes in a multi-ethnic Asian cohort: a prospective study. BMC Pregnancy Childbirth. 2018 Mar 21;18(1):69. doi: 10.1186/s12884-018-1707-3.

Fogel A, Fries LR, McCrickerd K, Goh AT, Quah PL, Chan MJ, Toh JY, Chong YS, Tan KH, Yap F, Shek LP, Meaney MJ, Broekman BFP, Lee YS, Godfrey KM, Fong Chong MF, Forde CG. Oral processing behaviours that promote children's energy intake are associated with parent-reported appetitive traits: Results from the GUSTO cohort. Appetite. 2018 Jul 1;126:8-15. doi: 10.1016/j.appet.2018.03.011. Epub 2018 Mar 15.

Lim SX, Toh JY, van Lee L, Han WM, Shek LP, Tan KH, Yap F, Godfrey KM, Chong YS, Chong MF. Food Sources of Energy and Macronutrient Intakes among Infants from 6 to 12 Months of Age: The Growing Up in Singapore Towards Healthy Outcomes (GUSTO) Study. Int J Environ Res Public Health. 2018 Mar 10;15(3):488. doi: 10.3390/ijerph15030488.

Chia AR, Tint MT, Han CY, Chen LW, Colega M, Aris IM, Chua MC, Tan KH, Yap F, Shek LP, Chong YS, Godfrey KM, Fortier MV, Lee YS, Chong MF. Adherence to a healthy eating index for pregnant women is associated with lower neonatal adiposity in a multiethnic Asian cohort: the Growing Up in Singapore Towards healthy Outcomes (GUSTO) Study. Am J Clin Nutr. 2018 Jan 1;107(1):71-79. doi: 10.1093/ajcn/nqx003.

Lin X, Teh AL, Chen L, Lim IY, Tan PF, MacIsaac JL, Morin AM, Yap F, Tan KH, Saw SM, Lee YS, Holbrook JD, Godfrey KM, Meaney MJ, Kobor MS, Chong YS, Gluckman PD, Karnani N. Choice of surrogate tissue influences neonatal EWAS findings. BMC Med. 2017 Dec 5;15(1):211. doi: 10.1186/s12916-017-0970-x.

Chen LW, Tint MT, Fortier MV, Aris IM, Shek LP, Tan KH, Chan SY, Gluckman PD, Chong YS, Godfrey KM, Rajadurai VS, Yap F, Kramer MS, Lee YS. Which anthropometric measures best reflect neonatal adiposity? Int J Obes (Lond). 2018 Mar;42(3):501-506. doi: 10.1038/ijo.2017.250. Epub 2017 Oct 9.

Bernard JY, Padmapriya N, Chen B, Cai S, Tan KH, Yap F, Shek L, Chong YS, Gluckman PD, Godfrey KM, Kramer MS, Saw SM, Muller-Riemenschneider F. Predictors of screen viewing time in young Singaporean children: the GUSTO cohort. Int J Behav Nutr Phys Act. 2017 Sep 5;14(1):112. doi: 10.1186/s12966-017-0562-3.

Aris IM, Bernard JY, Chen LW, Tint MT, Pang WW, Soh SE, Saw SM, Shek LP, Godfrey KM, Gluckman PD, Chong YS, Yap F, Kramer MS, Lee YS. Modifiable risk factors in the first 1000 days for subsequent risk of childhood overweight in an Asian cohort: significance of parental overweight status. Int J Obes (Lond). 2018 Jan;42(1):44-51. doi: 10.1038/ijo.2017.178. Epub 2017 Jul 28.

Loy SL, Wee PH, Colega MT, Cheung YB, Aris IM, Chan JKY, Godfrey KM, Gluckman PD, Tan KH, Shek LP, Chong YS, Natarajan P, Muller-Riemenschneider F, Lek N, Rajadurai VS, Tint MT, Lee YS, Chong MF, Yap F. Maternal Night-Fasting Interval during Pregnancy Is Directly Associated with Neonatal Head Circumference and Adiposity in Girls but Not Boys. J Nutr. 2017 Jul;147(7):1384-1391. doi: 10.3945/jn.117.250639. Epub 2017 Jun 7.

Loo EX, Goh A, Aris IBM, Teoh OH, Shek LP, Lee BW, Chan YH, Tint MT, Soh SE, Saw SM, Gluckman P, Godfrey KM, Chong YS, Yap F, Kramer MS, Van Bever H, Lee YS. Effects of infant weight gain on subsequent allergic outcomes in the first 3 years of life. BMC Pediatr. 2017 Jun 2;17(1):134. doi: 10.1186/s12887-017-0890-0.

Loo EXL, Sim JZT, Loy SL, Goh A, Chan YH, Tan KH, Yap F, Gluckman PD, Godfrey KM, Van Bever H, Lee BW, Chong YS, Shek LP, Koh MJA, Ang SB. Associations between caesarean delivery and allergic outcomes: Results from the GUSTO study. Ann Allergy Asthma Immunol. 2017 May;118(5):636-638. doi: 10.1016/j.anai.2017.02.021. No abstract available.

Loy SL, Ng MJH, Cheung YB, Godfrey KM, Calder PC, Lek N, Yap F, Muller-Riemenschneider F, Natarajan P, Chong YS, Tan KH, Shek LP, Chong MF, Chan JKY. Plasma omega-3 fatty acids in pregnancy are inversely associated with postpartum weight retention in a multiethnic Asian cohort. Am J Clin Nutr. 2017 May;105(5):1158-1165. doi: 10.3945/ajcn.116.151258. Epub 2017 Mar 22.

Pang WW, Colega M, Cai S, Chan YH, Padmapriya N, Chen LW, Soh SE, Han WM, Tan KH, Lee YS, Saw SM, Gluckman PD, Godfrey KM, Chong YS, van Dam RM, Chong MF. Higher Maternal Dietary Protein Intake Is Associated with a Higher Risk of Gestational Diabetes Mellitus in a Multiethnic Asian Cohort. J Nutr. 2017 Apr;147(4):653-660. doi: 10.3945/jn.116.243881. Epub 2017 Mar 8.

Lin X, Lim IY, Wu Y, Teh AL, Chen L, Aris IM, Soh SE, Tint MT, MacIsaac JL, Morin AM, Yap F, Tan KH, Saw SM, Kobor MS, Meaney MJ, Godfrey KM, Chong YS, Holbrook JD, Lee YS, Gluckman PD, Karnani N; GUSTO study group. Developmental pathways to adiposity begin before birth and are influenced by genotype, prenatal environment and epigenome. BMC Med. 2017 Mar 7;15(1):50. doi: 10.1186/s12916-017-0800-1.

Fogel A, Goh AT, Fries LR, Sadananthan SA, Velan SS, Michael N, Tint MT, Fortier MV, Chan MJ, Toh JY, Chong YS, Tan KH, Yap F, Shek LP, Meaney MJ, Broekman BFP, Lee YS, Godfrey KM, Chong MFF, Forde CG. A description of an 'obesogenic' eating style that promotes higher energy intake and is associated with greater adiposity in 4.5year-old children: Results from the GUSTO cohort. Physiol Behav. 2017 Jul 1;176:107-116. doi: 10.1016/j.physbeh.2017.02.013. Epub 2017 Feb 14.

Chen LW, Aris IM, Bernard JY, Tint MT, Colega M, Gluckman PD, Tan KH, Shek LP, Chong YS, Yap F, Godfrey KM, van Dam RM, Chong MF, Lee YS. Associations of maternal macronutrient intake during pregnancy with infant BMI peak characteristics and childhood BMI. Am J Clin Nutr. 2017 Mar;105(3):705-713. doi: 10.3945/ajcn.116.148270. Epub 2017 Feb 8.

Chia AR, de Seymour JV, Colega M, Chen LW, Chan YH, Aris IM, Tint MT, Quah PL, Godfrey KM, Yap F, Saw SM, Baker PN, Chong YS, van Dam RM, Lee YS, Chong MF. A vegetable, fruit, and white rice dietary pattern during pregnancy is associated with a lower risk of preterm birth and larger birth size in a multiethnic Asian cohort: the Growing Up in Singapore Towards healthy Outcomes (GUSTO) cohort study. Am J Clin Nutr. 2016 Nov;104(5):1416-1423. doi: 10.3945/ajcn.116.133892. Epub 2016 Oct 12. Erratum In: Am J Clin Nutr. 2018 Mar 1;107(3):484.

van Lee L, Tint MT, Aris IM, Quah PL, Fortier MV, Lee YS, Yap FK, Saw SM, Godfrey KM, Gluckman PD, Chong YS, Kramer MS, Chong MF. Prospective associations of maternal betaine status with offspring weight and body composition at birth: the Growing Up in Singapore Towards healthy Outcomes (GUSTO) cohort study. Am J Clin Nutr. 2016 Nov;104(5):1327-1333. doi: 10.3945/ajcn.116.138818. Epub 2016 Sep 21.

Loy SL, Chan JK, Wee PH, Colega MT, Cheung YB, Godfrey KM, Kwek K, Saw SM, Chong YS, Natarajan P, Muller-Riemenschneider F, Lek N, Chong MF, Yap F. Maternal Circadian Eating Time and Frequency Are Associated with Blood Glucose Concentrations during Pregnancy. J Nutr. 2017 Jan;147(1):70-77. doi: 10.3945/jn.116.239392. Epub 2016 Oct 19.

Aris IM, Bernard JY, Chen LW, Tint MT, Pang WW, Lim WY, Soh SE, Saw SM, Godfrey KM, Gluckman PD, Chong YS, Yap F, Kramer MS, Lee YS. Infant body mass index peak and early childhood cardio-metabolic risk markers in a multi-ethnic Asian birth cohort. Int J Epidemiol. 2017 Apr 1;46(2):513-525. doi: 10.1093/ije/dyw232.

Chen LW, Tint MT, Fortier MV, Aris IM, Bernard JY, Colega M, Gluckman PD, Saw SM, Chong YS, Yap F, Godfrey KM, Kramer MS, van Dam RM, Chong MF, Lee YS. Maternal Macronutrient Intake during Pregnancy Is Associated with Neonatal Abdominal Adiposity: The Growing Up in Singapore Towards healthy Outcomes (GUSTO) Study. J Nutr. 2016 Aug;146(8):1571-9. doi: 10.3945/jn.116.230730. Epub 2016 Jul 6.

Cheng TS, Loy SL, Toh JY, Cheung YB, Chan JK, Godfrey KM, Gluckman PD, Saw SM, Chong YS, Lee YS, Lek N, Chong MF, Yap F. Predominantly nighttime feeding and weight outcomes in infants. Am J Clin Nutr. 2016 Aug;104(2):380-8. doi: 10.3945/ajcn.116.130765. Epub 2016 Jul 6.

Quah PL, Cheng TS, Cheung YB, Yap F, Saw SM, Godfrey KM, Gluckman PD, Chong YS, Chong MF. Maternal and infant correlates of maternal feeding beliefs and practices in a multi-ethnic Asian population: the GUSTO (Growing Up in Singapore Towards healthy Outcomes) study. Public Health Nutr. 2016 Oct;19(15):2789-98. doi: 10.1017/S1368980016000744. Epub 2016 Apr 28.

Tint MT, Fortier MV, Godfrey KM, Shuter B, Kapur J, Rajadurai VS, Agarwal P, Chinnadurai A, Niduvaje K, Chan YH, Aris IB, Soh SE, Yap F, Saw SM, Kramer MS, Gluckman PD, Chong YS, Lee YS. Abdominal adipose tissue compartments vary with ethnicity in Asian neonates: Growing Up in Singapore Toward Healthy Outcomes birth cohort study. Am J Clin Nutr. 2016 May;103(5):1311-7. doi: 10.3945/ajcn.115.108738. Epub 2016 Apr 6.

Cheng TS, Loy SL, Cheung YB, Chan JK, Pang WW, Godfrey KM, Gluckman PD, Kwek K, Saw SM, Chong YS, Lee YS, Lek N, Yap F. Sexually dimorphic response to feeding mode in the growth of infants. Am J Clin Nutr. 2016 Feb;103(2):398-405. doi: 10.3945/ajcn.115.115493. Epub 2015 Dec 30.

Quah PL, Chan YH, Aris IM, Pang WW, Toh JY, Tint MT, Broekman BF, Saw SM, Kwek K, Godfrey KM, Gluckman PD, Chong YS, Meaney MJ, Yap FK, van Dam RM, Lee YS, Chong MF; GUSTO Study Group. Prospective associations of appetitive traits at 3 and 12 months of age with body mass index and weight gain in the first 2 years of life. BMC Pediatr. 2015 Oct 12;15:153. doi: 10.1186/s12887-015-0467-8.

Aris IM, Soh SE, Tint MT, Saw SM, Rajadurai VS, Godfrey KM, Gluckman PD, Yap F, Chong YS, Lee YS. Associations of gestational glycemia and prepregnancy adiposity with offspring growth and adiposity in an Asian population. Am J Clin Nutr. 2015 Nov;102(5):1104-12. doi: 10.3945/ajcn.115.117614. Epub 2015 Sep 30.

Aris IM, Soh SE, Tint MT, Saw SM, Rajadurai VS, Godfrey KM, Gluckman PD, Yap F, Chong YS, Lee YS. Associations of infant milk feed type on early postnatal growth of offspring exposed and unexposed to gestational diabetes in utero. Eur J Nutr. 2017 Feb;56(1):55-64. doi: 10.1007/s00394-015-1057-0. Epub 2015 Sep 28.

Chong MF, Ong YL, Calder PC, Colega M, Wong JX, Tan CS, Lim AL, Fisk HL, Cai S, Pang WW, Broekman BF, Saw SM, Kwek K, Godfrey KM, Chong YS, Gluckman P, Meaney MJ, Chen H; GUSTO Study Group. Long-chain polyunsaturated fatty acid status during pregnancy and maternal mental health in pregnancy and the postpartum period: results from the GUSTO study. J Clin Psychiatry. 2015 Jul;76(7):e848-56. doi: 10.4088/JCP.14m09191.

Lin X, Aris IM, Tint MT, Soh SE, Godfrey KM, Yeo GS, Kwek K, Chan JK, Gluckman PD, Chong YS, Yap F, Holbrook JD, Lee YS. Ethnic Differences in Effects of Maternal Pre-Pregnancy and Pregnancy Adiposity on Offspring Size and Adiposity. J Clin Endocrinol Metab. 2015 Oct;100(10):3641-50. doi: 10.1210/jc.2015-1728. Epub 2015 Jul 22.

Chong MF, Chia AR, Colega M, Tint MT, Aris IM, Chong YS, Gluckman P, Godfrey KM, Kwek K, Saw SM, Yap F, van Dam RM, Lee YS; GUSTO Study Group. Maternal Protein Intake during Pregnancy Is Not Associated with Offspring Birth Weight in a Multiethnic Asian Population. J Nutr. 2015 Jun;145(6):1303-10. doi: 10.3945/jn.114.205948. Epub 2015 May 6.

Cai S, Pang WW, Low YL, Sim LW, Sam SC, Bruntraeger MB, Wong EQ, Fok D, Broekman BF, Singh L, Richmond J, Agarwal P, Qiu A, Saw SM, Yap F, Godfrey KM, Gluckman PD, Chong YS, Meaney MJ, Kramer MS, Rifkin-Graboi A; GUSTO Study Group. Infant feeding effects on early neurocognitive development in Asian children. Am J Clin Nutr. 2015 Feb;101(2):326-36. doi: 10.3945/ajcn.114.095414. Epub 2014 Dec 10.

Aris IM, Gandhi M, Cheung YB, Soh SE, Tint MT, Gluckman PD, Lee YS, Yap FK, Chong YS. A new population-based reference for gestational age-specific size-at-birth of Singapore infants. Ann Acad Med Singap. 2014 Sep;43(9):439-47.

Chong MF, Wong JX, Colega M, Chen LW, van Dam RM, Tan CS, Lim AL, Cai S, Broekman BF, Lee YS, Saw SM, Kwek K, Godfrey KM, Chong YS, Gluckman P, Meaney MJ, Chen H; GUSTO study group. Relationships of maternal folate and vitamin B12 status during pregnancy with perinatal depression: The GUSTO study. J Psychiatr Res. 2014 Aug;55:110-6. doi: 10.1016/j.jpsychires.2014.04.006. Epub 2014 Apr 16.

Aris IM, Soh SE, Tint MT, Liang S, Chinnadurai A, Saw SM, Rajadurai VS, Kwek K, Meaney MJ, Godfrey KM, Gluckman PD, Yap FK, Chong YS, Lee YS. Effect of maternal glycemia on neonatal adiposity in a multiethnic Asian birth cohort. J Clin Endocrinol Metab. 2014 Jan;99(1):240-7. doi: 10.1210/jc.2013-2738. Epub 2013 Dec 20.

• Responsible Party: National University Hospital, Singapore
• ClinicalTrials.gov Identifier: NCT01174875
• Other Study ID Numbers: CIRB/E/2019/2655; NMRC/TCR/004-NUS/2008 ( Other Grant/Funding Number: National Medical Research Council ); NMRC/TCR/012-NUHS/2014 ( Other Grant/Funding Number: National Medical Research Council ); MOH-000504 ( Other Grant/Funding Number: National Medical Research Council )
• First Posted: August 4, 2010
• Last Update Posted: January 23, 2023
• Last Verified: January 2023

Individual Participant Data (IPD) Sharing Statement:

• Plan to Share IPD: No

• Studies a U.S. FDA-regulated Drug Product: No
• Studies a U.S. FDA-regulated Device Product: No

Keywords provided by National University Hospital, Singapore:

Epigenetics; Development; Metabolic; Neurodevelopment

Additional relevant MeSH terms:

Metabolic Diseases