Publications by authors named "Keith M Godfrey"

Introduction: Low health literacy levels during adolescence and young adulthood (AYA) may impact acute healthcare access and longer-term health outcomes. Previous research in South African AYA suggests that health literacy levels are typically suboptimal but few interventions exist. This study aimed to test the acceptability and feasibility of a co-created, interactive health literacy intervention (LifeLab-Soweto) with AYA in Soweto, South Africa.

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  • * In a sample of 382 Asian women planning to conceive, the research identifies a new liver fat cutoff of 2.07% for diagnosing MetS, with trends indicating worsened MetS traits and plasma metabolomic changes as liver fat increases.
  • * Results show that preconception liver fat levels significantly correlate with the risk of gestational diabetes, with moderate liver fat (2.07% to 5.56%) doubling and high liver fat (≥5.56%) increasing the risk seven
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  • Mitochondrial calcium uniporter (MCU) plays a crucial role in calcium uptake and energy metabolism, especially during muscle contractions, but its therapeutic potential in aging-related muscle decline is not well understood.
  • Research reveals that the regulator MCUR1 is downregulated in aging muscles, leading to reduced mitochondrial calcium uptake and impaired energy production, contributing to sarcopenia (muscle loss).
  • The natural compound oleuropein has been identified as an activator of MCU, which enhances mitochondrial function and endurance in both young and older mice, indicating its potential as a food-derived treatment for age-related muscle dysfunction.
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  • A multinational trial, NiPPeR, tested a nutritional formulation vs. a standard supplement in pregnant women and aimed to improve maternal health and pregnancy outcomes.
  • The primary outcome showed no difference in gestational glycemia, but the intervention resulted in significant benefits, such as reduced preterm delivery rates and shorter conception time for overweight women.
  • Overall, the study suggests that preconception nutritional interventions can positively influence both maternal health and long-term outcomes for infants, potentially reducing the risk of chronic diseases later in life.
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Background: Preconception medical, behavioural and socioeconomic risk factors are common among people of reproductive age and can impact pregnancy and offspring outcomes. In line with clinical guidance, primary care practitioners are encouraged to support patients to manage and optimise their health prior to pregnancy. Due to barriers, including lack of time and resources, this support is not currently part of routine practice.

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Local government is well placed to provide leadership for the national ambition in England to halve childhood obesity by 2030 and has delegated authority for many policies thought necessary for effective action. However, with currently constrained local government finances, resources may not be prioritized for the wide range of policies and interventions necessary. Thus, local political commitment is vital for directing local government investment to tackle the issue.

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Background: Body mass index (BMI) trajectories have been used to assess the growth of children with respect to their peers, and to anticipate future obesity and disease risk. While retrospective BMI trajectories have been actively studied, models to prospectively predict continuous BMI trajectories have not been investigated.

Materials And Methods: Using longitudinal BMI measurements between birth and age 10 y from a mother-offspring cohort, we leveraged a multi-task Gaussian process approach to develop and evaluate a unified framework for modeling, clustering, and prospective prediction of BMI trajectories.

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  • This study explored how early gestational glucose levels, measured by continuous glucose monitoring (CGM), relate to the later development of insulin resistance (IR) and gestational diabetes mellitus (GDM) in pregnant women.
  • In a cohort of 167 pregnant women, 25% were found to have IR and 18% developed GDM, with higher early glucose levels and variability in glucose readings linked to increased risk of both conditions.
  • Results indicated that women with suboptimal glycemic control showed higher mean daily glucose and variability, which correlated with a significantly greater risk of developing IR and GDM as pregnancy progressed.
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Background: Maternal preconception and pregnancy exposures have been linked to offspring adiposity. We aimed to quantify the effect of changes in maternal weight and smoking status between pregnancies on childhood overweight/obesity (≥ 85th centile) and obesity (≥ 95th centile) rates in second children.

Methods: Records for 5612 women were drawn from a population-based cohort of routinely collected antenatal healthcare records (2003-2014) linked to measured child body mass index (BMI) age 4-5 years.

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Background: Findings from the Maternal Vitamin D Osteoporosis Study (MAVIDOS) trial demonstrated a positive effect of gestational cholecalciferol supplementation on offspring bone mineral density (BMD) at age 4 y. Demonstrating the persistence of this effect is important to understanding whether maternal vitamin D supplementation could be a useful public health strategy to improving bone health.

Objectives: We investigated whether gestational vitamin D supplementation increases offspring BMD at ages 6-7 y in an exploratory post-hoc analysis of an existing trial.

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Background: Maternal feeding practices play a major role in children's dietary intakes. However, there is limited data on the associations between trajectories of dietary patterns (DPs) and patterns of maternal feeding practices during early childhood.

Methods: Using data from a multi-ethnic Asian cohort study, namely the Growing Up in Singapore Towards healthy Outcomes (GUSTO), dietary intakes were measured using Food Frequency Questionnaires in children at 18 months, 5 and 7 years of age.

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  • - Researchers studied how a mother's diet quality and eating habits during pregnancy affect her child's metabolic health, particularly focusing on weight and insulin resistance in children by age 6.
  • - They found that a better diet quality during pregnancy was linked to lower insulin resistance in children, while mothers who mainly ate at night tended to have offspring with higher insulin resistance, especially among boys.
  • - Overall, the study highlights the significance of maternal eating patterns and diet quality during pregnancy, suggesting both factors can influence a child’s metabolic health, with stronger effects observed in male children and in those exposed to lower diet quality.
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  • A study examined how physical activity, sedentary behavior, and sleep—collectively known as 24-h movement behaviors—affect cognitive development in children, specifically focusing on executive function and academic performance.
  • The research involved 432 children in Singapore aged 5.5 to 9 years, using wrist-worn accelerometers to accurately measure their movement behaviors and various cognitive assessments to gauge outcomes.
  • Findings revealed that while overall 24-h movement behaviors didn't link to cognitive performance, reallocating time from moderate-to-vigorous physical activity to sleep improved academic achievement scores.
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Introduction: There is growing scientific and policy recognition that optimising health before a potential pregnancy (preconception health) improves reproductive outcomes and the lifelong health of future children. However, public awareness on this topic is low. We conducted a public consultation to develop language recommendations and identify and prioritise approaches to inform research and improve public awareness of preconception health.

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Objective: To characterise lifestyle patterns (comprising dietary and movement behaviour aspects) of children in Singapore and examine the correlates of these patterns.

Design: An observational study approach was used. Children recorded their diet and activities over two weekdays and two weekend days on a validated web-based assessment, My E-Diary for Activities and Lifestyle (MEDAL).

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We previously reported that a combined -inositol, probiotics, and enriched micronutrient supplement (intervention) taken preconception and in pregnancy reduced postpartum blood loss (PBL) and major postpartum hemorrhage compared with a standard micronutrient supplement (control), as secondary outcomes of the NiPPeR trial. This study aimed to identify the intervention components that may contribute to this effect. Associations of plasma concentrations of -inositol and vitamins B2, B6, B12, and D at preconception (before and after supplementation), early (~7-weeks), and late pregnancy (~28-weeks) with PBL were assessed by multiple linear regression, adjusting for site, ethnicity, preconception BMI, parity, and previous cesarean section.

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  • Preconception is crucial for optimizing gamete function and placental development, but the lack of services has led to declining fertility rates and unhealthy pregnancies. A community-level preconception care program is urgently needed.* -
  • The proposed solution is a user-friendly mobile app that allows couples to assess their fecundability risks and receive personalized management plans, promoting better reproductive health.* -
  • This digital intervention aims to shift couples' perceptions about subfertility and facilitate ongoing behavior change, ultimately creating a framework for future preconception care delivery.*
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Healthcare professionals (HCPs) have vital roles in providing evidence-based care to promote healthy micronutrient nutrition in early life. Providing such care requires scalable training to strengthen knowledge and confident application of effective behaviour change skills. Among 33 public and private HCPs (primarily dietitians) in South Africa, we evaluated the behaviour change aspects of a technology-enabled National Qualification Sub-Framework level 6 programme, Improving Early Nutrition and Health in South Africa ('ImpENSA').

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Background: We previously reported that delayed allergenic food introduction in infancy did not increase food allergy risk until age 4 y within our prospective cohort. However, it remains unclear whether other aspects of maternal or infant diet play roles in the development of childhood food allergy.

Objectives: We examined the relationship between maternal pregnancy and infant dietary patterns and the development of food allergies until age 8 y.

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Studies examining preconception eating behaviours with longitudinal dietary patterns from preconception to late pregnancy as well as gestational weight gain (GWG) are limited. We derived dietary pattern trajectories from preconception to late-pregnancy, and related preconception eating behaviours to these trajectories and GWG. Preconception eating behaviours were assessed using the Three-Factor Eating Questionnaire measuring cognitive restraint (CR) - conscious restriction of food intake, emotional eating (EE) - overeating in response to negative emotions, and uncontrolled eating (UE) - overeating with a feeling of lack of control.

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  • Mitochondrial dysfunction and low NAD levels are linked to aging and muscle loss (sarcopenia), but it's unclear if these issues come from local or systemic factors.
  • Research shows that trigonelline, a natural compound similar to nicotinic acid, positively affects NAD levels and muscle health across different species, including humans.
  • Trigonelline enhances mitochondrial function, reduces muscle wasting, and increases strength and lifespan, suggesting that dietary trigonelline could be a helpful strategy against age-related muscle decline.
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Background: Parental practices and neighbourhood environmental factors may influence children's movement behaviours. We aimed to investigate the cross-sectional and prospective associations of parental practices and neighbourhood environmental factors with accelerometer-measured 24-hour movement behaviours (24 h-MBs) among school-aged children in Singapore.

Methods: The Growing Up in Singapore Towards healthy Outcomes (GUSTO) study collected information on dimensions of parental practices and neighbourhood environment at age 5.

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Introduction: Poor cognitive function and osteoporosis commonly co-exist in later life. In women, this is often attributed to post-menopausal estrogen loss. However, a common early life origin for these conditions and the associations between cognitive function and bone mineral density (BMD) in childhood have not previously been explored.

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