Published on 13 June 2024

    From eating speeds to a mother’s mental health during pregnancy, there are many factors and behaviours that could potentially have a lasting impact on a child’s life.

    The Growing Up in Singapore Towards healthy Outcomes (GUSTO) cohort study, which began in October 2008, explores how conditions experienced during pregnancy and early childhood can influence the development and health outcomes of both women and their children.

    This long-term study – a collaboration between A*STAR's Singapore Institute for Clinical Sciences, KK Women's and Children's Hospital (KKH), National University Health System (NUHS) and the National University of Singapore (NUS) – involves the tracking of a cohort of mothers and their children from birth. 

    The GUSTO cohort study, which currently has 882 active participants, seeks to provide valuable insights into the prevention and management of important diseases in Singapore, thereby contributing to the improvement of the nation's health.

    Here are some key findings that have been gleaned from the ongoing study so far.

    #1 The benefits of sleep

    It is no secret that adequate sleep is vital for both physical and mental health. But, just how important is it for children in their overall development?

    According to a GUSTO study, children with longer and consistent sleep patterns are more likely to perform better in school, particularly in language and mathematics tests, which are significant indicators of academic success.

    Sleep is also important for mothers – in another GUSTO study, it was found that pregnant women who get less than six hours of sleep a night are almost twice as likely to get gestational diabetes (GDM) compared with those who sleep for seven to eight hours.

    #2 The importance of a healthy diet

    We all know the adage: you are what you eat. But is that actually true?

    Based on the findings of a GUSTO study which examined the nutrient intake of infants and its correlation with brain development, our diet can shape not only our physical health, but also our cognitive abilities.

    The study analysed one-day food records of participating children at six, nine and 12 months, and later measured their development and intelligence at 24 months.

    It was found that children who consumed a higher-protein diet exhibited better fine motor skills, which refer to the ability to make precise movements using the small muscles in our hands and wrists. Similarly, an increase in dietary fibre intake also yielded similar results.

    When measuring receptive language scores, which assess a child's ability to understand and comprehend language, researchers found a positive correlation with consistent fat intake and an increase in carbohydrate consumption from six to 12 months.

    #3 The dangers of excessive screen time

    It has become increasingly common to see parents providing their young child with mobile devices for entertainment.

    However, infants and children who spend long hours gawking at screens could find their cognitive abilities lowered. This decline in brain function could last beyond early childhood and even impair future learning.

    After gathering data on the daily screen time of 506 children from the GUSTO cohort, researchers found that those who had more screen time exhibited reduced cognitive alertness and generally had poorer attention spans.

    A 2017 GUSTO study also noted a correlation between screen time and a child’s physical health. Due to longer periods of physical inactivity – which occurs when the child is engaged with a mobile device – children with more screen time from the ages of two to three are more likely to have a higher body fat percentage when they turn five.

    #4 A possible link between fast eaters and body weight

    GUSTO cohort children consumed more calories when they selected larger portion sizes for their lunch, ate faster by taking larger bites, and chewed their food less.

    A video study observed that children who ate faster consumed 75 per cent more calories than those who ate at a slower pace. These findings support the importance of teaching children self-regulation, and how to eat slower as a strategy to reduce food intake and promote healthy body weight.

    #5 Happier mums help babies slumber better

    Many parents struggle with the challenge of getting their baby to sleep through the night, but a 2022 GUSTO study suggests there may be a straightforward solution: keep the mothers happy.

    The study examined the mental health of 797 mothers at approximately 27 weeks’ gestation, as well as three months after giving birth. It also studied the sleep data of their children at three, six, nine and 12 months’ old. 

    The results indicated a clear correlation – expectant mothers with poorer mental health during mid-pregnancy tend to have infants who struggle to sleep at night for longer periods, and vice versa.

    #6 Eating vegetables, fruit, and white rice can lower risk of preterm birth

    There are many dos and don’ts when it comes to food consumption during pregnancy. According to a GUSTO cohort study, the group of mothers-to-be that ate a diet largely comprising vegetables, fruit and white rice was associated with a lower risk of preterm births.

    This is attributed to the diet being low in saturated fat, high in fibre, and likely rich in phytochemicals and antioxidants from fruits and vegetables. Conversely, it was reported in another research that expectant mothers who ate a diet high in processed meat, fried potatoes, white bread, and fried meat were at a higher risk of preterm birth. 

    There are ultimately a multitude of factors during pregnancy and early childhood that could potentially impact a person’s adult life. By uncovering key findings with the help of the GUSTO cohort study, scientists can empower Singaporeans to work towards a healthier next generation.

    In consultation with Prof Johan Gunnar Eriksson, Director, Translational Research Programme (Human Potential), Yong Loo Lin School of Medicine (NUS Med).

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