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Metabolic DiseasesGUSTONCT01174875

Growing Up in Singapore Towards Healthy Outcomes

An observational study of Metabolic Diseases and Neurological and Mental Health Conditions, run by National University Hospital, Singapore at 1 site in Singapore.

Active, not recruiting

Under way, not looking for participants. Everyone needed has enrolled. The study is still running.

Official record
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Trial summary

This study aims to examine the role of genetic and epigenetic factors, maternal nutrition, lifestyle, emotional health, and other environmental factors in pregnancy or postpartum period that can influence future maternal risk of metabolic and mental wellness, including body weight changes. Read more about this study

Who is it for?
Any ageHealthy volunteers can take part
How many people
1,247 participants
Where
1 siteSingapore
Study dates
Jun 2009to Jul 2029
Phase
Observational
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages Any age
  • All sexes
  • Healthy volunteers accepted
  • Child, Adult, Older adult

Study population: Pregnant women attending their first-trimester antenatal visit at public maternity units in KKH and NUH, along with their children born from the indexed pregnancy.

Who may be able to join

  • 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

Who cannot join

  • 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
  • Babies born from these mothers will be invited to participate and followed up until the child is at least 20 years of age.

Trial locations and contacts

1 site in 1 country.

Singapore1 site

  • National University Hospital

    Singapore, Singapore

Other trials in Singapore

About this study

Official title: Developmental Pathways to Health and Disease: Metabolic, Neurodevelopmental and Related Outcomes

This study aims to examine the role of genetic and epigenetic factors, maternal nutrition, lifestyle, emotional health, and other environmental factors in pregnancy or postpartum period that can influence future maternal risk of metabolic and mental wellness, including body weight changes. The study will recruit women in early pregnancy and later follow their children after birth, tracking both the mother and child until the child reaches at least 20 years of age.

Read the 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. In continuation of this research, participants will continue to be followed up through their adolescence phase from the age of 10 to 20 years.

Data will be collected through questionnaires and measurements.

  • Questionnaires may be related to socioeconomic factors, healthcare expenses, diet, medical history, behaviour, cognition, lifestyle, sleep, health status, social-emotion factors, and home environment.
  • Body measurements such as height, weight, blood pressure, body composition analysis involving bioelectrical impedance analysis (BIA), grip strength.
  • Dental examination
  • Child pubertal assessments
  • Skin clinical assessment and digital photography for assessment of acne presence and severity
  • Monitoring physical activity level and sedentary behaviour by using an accelerometer
  • Using mobile phone app to collect information about your child's mobile phone usage patterns, activities etc.
  • Collection of samples e.g. blood, buccal swabs, saliva, hair, urine, stool, skin samples, oral specimen such as exfoliated milk teeth, dental plaque and tongue biofilms
Keywords
Epigenetics, Development, Metabolic, Neurodevelopment, Cohort Study, Birth Cohort, Longitudinal Study, Pregnancy, Growth, Developmental Origins of Health and Disease, DOHaD, Epidemiology, Maternal Health, Infant Health, Child Health, Health Outcomes, Postnatal Exposure, Perinatal Exposure, Environmental Factors, Nutrition
Medical subject headings
Metabolic Diseases, Neurologic Manifestations, Genetic Predisposition to Disease, Skin Diseases, Developmental Origins of Health and Disease

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

Study groups in NCT01174875
Study groupRoleWhat they receive
Pregnant mothers, infants and childrenWomen 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 20 years of age.

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Roles of fetal, developmental and epigenetic factors in pathways to disease

    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.

    Measured: Perinatal

Secondary outcomes (3)

  1. Influence of prenatal and early postnatal factors on child health

    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.

    Measured: During pregnancy and infancy period

  2. Effect of factors in pregnancy and early postpartum period on maternal health

    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.

    Measured: During pregnancy and postpartum period

  3. Influence genetic and epigenetics factors in combination with lifestyle on child health

    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.

    Measured: Childhood and Adolescence up to age 20

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted4 Aug 2010 (estimated)
  2. Study startJun 2009
  3. Primary completionJul 2029 (estimated)
  4. Study completionJul 2029 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Prospective
Enrolment
1,247 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01174875
Sponsor's protocol ID
CIRB 2019/2655/E
Other IDs
NMRC/TCR/004-NUS/2008, NMRC/TCR/012-NUHS/2014, MOH-000504
Acronym
GUSTO
Status last verified
Mar 2025
First submitted
1 Jul 2010
Last updated
9 Feb 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Soh SE, Tint MT, Gluckman PD, Godfrey KM, Rifkin-Graboi A, Chan YH, Stunkel W, Holbrook JD, Kwek K, Chong YS, Saw SM; GUSTO Study Group. Cohort profile: Growing Up in Singapore Towards healthy Outcomes (GUSTO) birth cohort study. Int J Epidemiol. 2014 Oct;43(5):1401-9. doi: 10.1093/ije/dyt125. Epub 2013 Aug 2. No abstract available.

    PubMed 23912809

  • Gridneva Z, Pang WW, Vlaskovsky P, McEachran JL, Perrella SL, Michael N, Gupta V, Yap F, Lee YS, Vasanwala RF, Wlodek ME, Godfrey KM, Chong YS, Eriksson JG, Geddes DT, Tint MT. Breastfeeding duration and bone mineral density in childhood: a prospective study within the Growing Up in Singapore Toward healthy Outcomes (GUSTO) cohort. Am J Clin Nutr. 2026 Jul;124(1):101347. doi: 10.1016/j.ajcnut.2026.101347. Epub 2026 May 13.

    PubMed 42134412

  • Vainqueur C, Padmapriya N, Tint MT, Yap F, Lee YS, Saw SM, Tan KH, Shek LP, Chong YS, Godfrey KM, Eriksson JG, Lioret S, Heude B, Muller-Riemenschneider F, Bernard JY, Poncet L. Longitudinal associations between screen time and whole-body adiposity during the first decade of life: insights from the GUSTO cohort. Int J Obes (Lond). 2026 May;50(5):1097-1104. doi: 10.1038/s41366-026-02046-x. Epub 2026 Mar 9.

    PubMed 41803381

  • Lazarus MA, Franzolini B, Eriksson JG, Chong MF, Ying TJ, de Iorio M, Meaney MJ, Godfrey KM, Yap F, Chen H, Chong YS, Kee MZL, Fogel AM. Feeding practices and concerns as mediators between maternal mental health and eating behaviours in early childhood. Appetite. 2026 Feb 1;217:108340. doi: 10.1016/j.appet.2025.108340. Epub 2025 Oct 10.

    PubMed 41077073

  • Pang WW, Geddes DT, Lai CT, Michael N, Huang J, Chan YH, Cheong CY, Fok D, Pundir S, Ng S, Vickers MH, Chua MC, Tan KH, Godfrey KM, Shek LP, Chong YS, Eriksson JG, Chan SY, Wlodek ME. The prospective associations of fetal growth-related pregnancy complications with subsequent breastfeeding duration and markers of human milk production. Am J Clin Nutr. 2025 Feb;121(2):478-487. doi: 10.1016/j.ajcnut.2024.11.008. Epub 2024 Nov 13.

    PubMed 39542219

  • Han MX, Nadarajan R, Wang N, Kee MZL, Lim S, Sagar YK, Chow B, Tan AP, Cheon BK, Ang YS, Zhou JH, Chen HY, Chong YS, Gluckman PD, Meaney MJ, Law EC. Maternal Depressive Symptoms and Risk for Childhood Depression: Role of Executive Functions. J Am Acad Child Adolesc Psychiatry. 2025 Aug;64(8):946-958. doi: 10.1016/j.jaac.2024.08.503. Epub 2024 Oct 16.

    PubMed 39419473

  • Padmapriya N, Bernard JY, Tan SYX, Chu AHY, Goh CMJL, Tan SL, Shek LP, Chong YS, Tan KH, Chan SY, Yap F, Godfrey KM, Lee YS, Meaney MJ, Eriksson JG, Tan CS, Law EC, Muller-Riemenschneider F. The prospective associations of 24-hour movement behaviors and domain-specific activities with executive function and academic achievement among school-aged children in Singapore. Front Public Health. 2024 Sep 4;12:1412634. doi: 10.3389/fpubh.2024.1412634. eCollection 2024.

    PubMed 39296832

  • Xu J, Duar RM, Quah B, Gong M, Tin F, Chan P, Sim CK, Tan KH, Chong YS, Gluckman PD, Frese SA, Kyle D, Karnani N. Delayed colonization of Bifidobacterium spp. and low prevalence of B. infantis among infants of Asian ancestry born in Singapore: insights from the GUSTO cohort study. Front Pediatr. 2024 Jun 10;12:1421051. doi: 10.3389/fped.2024.1421051. eCollection 2024.

    PubMed 38915873

  • Padmapriya N, Fogel A, Tan SYX, Goh CMJL, Tan SL, Chia A, Chu AHY, Chong YS, Tan KH, Chan SY, Yap F, Godfrey KM, Lee YS, Eriksson JG, Tan CS, Bernard JY, Muller-Riemenschneider F. The cross-sectional and prospective associations of parental practices and environmental factors with 24-hour movement behaviours among school-aged Asian children. Int J Behav Nutr Phys Act. 2024 Mar 4;21(1):27. doi: 10.1186/s12966-024-01574-x.

    PubMed 38438945

  • Chia A, Toh JY, Natarajan P, Cai S, Ong YY, Descarpentrie A, Lioret S, Bernard JY, Muller-Riemenschneider F, Godfrey KM, Tan KH, Chong YS, Eriksson JG, Chong MF. Trajectories of lifestyle patterns from 2 to 8 years of age and cardiometabolic risk in children: the GUSTO study. Int J Behav Nutr Phys Act. 2024 Jan 26;21(1):9. doi: 10.1186/s12966-024-01564-z.

    PubMed 38279175

  • Ong YY, Pang WW, Michael N, Aris IM, Sadananthan SA, Tint MT, Liang Choo JT, Ling LH, Karnani N, Velan SS, Fortier MV, Tan KH, Gluckman PD, Yap F, Chong YS, Godfrey KM, Chan SY, Eriksson JG, Chong MF, Wlodek ME, Lee YS. Timing of introduction of complementary foods, breastfeeding, and child cardiometabolic risk: a prospective multiethnic Asian cohort study. Am J Clin Nutr. 2023 Jan;117(1):83-92. doi: 10.1016/j.ajcnut.2022.10.021. Epub 2022 Dec 21.

    PubMed 36789947

  • 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.

    PubMed 35871677

  • 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.

    PubMed 35788016

  • 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.

    PubMed 35433544

  • 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.

    PubMed 35073935

Questions about this trial

What is this clinical trial studying?

An observational study of Metabolic Diseases and Neurological and Mental Health Conditions, run by National University Hospital, Singapore at 1 site in Singapore.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 8 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: under way, not looking for participants, as of the sponsor's last update on 9 Feb 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Singapore. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Roles of fetal, developmental and epigenetic factors in pathways to disease (time frame: Perinatal). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT01174875, which also lists 74 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 9 Feb 2026.

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