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Review
. 2021 Aug 24;13(9):2932.
doi: 10.3390/nu13092932.

Studies to Improve Perinatal Health through Diet and Lifestyle among South Asian Women Living in Canada: A Brief History and Future Research Directions

Dipika Desai  1   2 , Sujane Kandasamy  2 , Jayneel Limbachia  3 , Michael A Zulyniak  4 , Paul Ritvo  5 , Diana Sherifali  1   2   6 , Gita Wahi  2   7 , Sonia S Anand  1   2   3 , Russell J de Souza  1   2
Affiliations
Review

Studies to Improve Perinatal Health through Diet and Lifestyle among South Asian Women Living in Canada: A Brief History and Future Research Directions

Dipika Desai et al. Nutrients. .

Abstract

South Asians (i.e., people who originate from India, Pakistan, Sri Lanka, Nepal, and Bangladesh) have higher cardiovascular disease rates than other populations, and these differences persist in their offspring. Nutrition is a critical lifestyle-related factor that influences fetal development, and infant and child health in early life. In high-income countries such as Canada, nutrition-related health risks arise primarily from overnutrition, most strikingly for obesity and associated non-communicable diseases. Evidence for developmental programming during fetal life underscores the critical influence of maternal diet on fetal growth and development, backed by several birth cohort studies including the Pune Maternal Nutrition Study, the South Asian Birth Cohort Study, and the Born in Bradford Study. Gestational diabetes mellitus is a strong risk factor for type 2 diabetes, future atherosclerosis and cardiovascular disease in the mother and increases the risk of type 2 diabetes in her offspring. Non-pharmacological trials to prevent gestational diabetes are few, often not randomized, and are heterogeneous with respect to design, and outcomes have not converged upon a single optimal prevention strategy. The aim of this review is to provide an understanding of the current knowledge around perinatal nutrition and gestational diabetes among the high-risk South Asian population as well as summarize our research activities investigating the role of culturally-tailored nutrition advice to South Asian women living in high-income settings such as Canada. In this paper, we describe these qualitative and quantitative studies, both completed and underway. We conclude with a description of the design of a randomized trial of a culturally tailored personalized nutrition intervention to reduce gestational glycaemia in South Asian women living in Canada and its implications.

Keywords: South Asians; culturally-tailored advice; gestational diabetes; healthy active living; infant and child health; maternal health; nutrition; perinatal; prospective cohort; randomized control trial.

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Conflict of interest statement

Russell de Souza has served as an external resource person to the World Health Organization’s Nutrition Guidelines Advisory Group on trans fats, saturated fats, and polyunsaturated fats. The WHO paid for his travel and accommodation to attend meetings from 2012–2017 to present and discuss this work. He has also done contract research for the Canadian Institutes of Health Research’s Institute of Nutrition, Metabolism, and Diabetes, Health Canada, and the World Health Organization, for which he received remuneration. He has received speaker’s fees from the University of Toronto and McMaster Children’s Hospital. He has held grants from the Canadian Institutes of Health Research, Canadian Foundation for Dietetic Research, Population Health Research Institute, and Hamilton Health Sciences Corporation as a principal investigator and is a co-investigator on several funded team grants from the Canadian Institutes of Health Research. He serves as a member of the Nutrition Science Advisory Committee to Health Canada (Government of Canada), a co-opted member of the Scientific Advisory Committee on Nutrition (SACN) Subgroup on the Framework for the Evaluation of Evidence (Public Health England), and as an independent director of the Helderleigh Foundation (Canada). Sujane Kandasamy received a CIHR video talks Prize for the Knowledge Translation (KT) video created for the South Asian Grandmothers Qualitative Substudy. She was also funded by a CIHR Vanier Doctoral scholarship to develop and evaluate the SMART START KT tools. Gita Wahi has held grants from the Canadian Institutes of Health Research, and she is currently the recipient of a Research Early Career Award from Hamilton Health Sciences Foundation. Paul Ritvo is currently funded by the Canadian Institutes of Health (CIHR) (2021–2025). He coordinates research with NexJ Health, Inc., which provides a software platform to convey the psychosocial and psychiatric programming he develops and assesses. Ritvo receives no personal compensations for studies coordinated with NexJ but does receive free-of-charge platform support. All other authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
The evolution of SA perinatal health in South Asian women research, inspired by the Barker hypothesis. The Barker hypothesis gave rise to birth cohort studies, which encouraged the development of culturally tailored interventions and evaluations.
See this image and copyright information in PMC

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