Epigenetic studies in children at risk of stunting and their parents in India, Indonesia and Senegal: A UKRI GCRF Action Against Stunting Hub protocol paper

Anouschka S. Ramsteijn, Magatte Ndiaye, Rajender Rao Kalashikam, Min Kyaw Htet, Dinesh Yadav Dm, Little Flower Augustine, Nur L. Zahra, Aicha Djigal, Dwi Yanti, Tiffany C. Angelin, Mifa Nurfadilah, Manjula Gorre, Dantham Subrahamanyam, Sai Santhosh Vadakattu, Manne Munikumar, Graham W. Horgan, Umi Fahmida, Babacar Faye, Bharati Kulkarni, Paul Haggarty

Research output: Contribution to journalArticlepeer-review


Introduction In 2020, an estimated 150 million children under the age of 5 years were stunted. Stunting results from early-life adversity and it is associated with significant physical and cognitive deficit, lifelong socioeconomic disadvantage and reduced life expectancy. There is a need to understand the causes of stunting and its effects in order to develop strategies to avoid it and to mitigate the consequences once stunting has occurred. Epigenetics is an important mechanism through which early-life factors are thought to influence biological function, with long-term consequences. We describe a series of epigenetic studies designed to understand how early-life adversity results in stunting and to inform the development of practical tools such as predictive markers and therapeutic targets. This work is part of the UKRI GCRF Action Against Stunting Hub. Methods and analysis The project - in India, Indonesia and Senegal - comprises an observational study of mothers, fathers, and offspring (n=500) spanning the first 1000 days of life, and an intervention study in each country. Epigenetic status (DNA methylation) is determined in saliva from babies collected within 1 month of birth and again at 18 months of age, and from mothers and fathers around the time of birth. Epigenome-wide analysis is carried out using the Illumina EPIC array, augmented by high-definition sequencing approaches. Statistical analysis is carried out at the level of candidate genes/regions, higher dimensional epigenetic states and epigenome-wide association. Data analysis focuses on the determinants of stunting, the effectiveness of interventions, population comparisons and the link between epigenetics and other thematic areas, which include anthropometry, microbiome, gut health, parasitology, cognition, nutrition, food hygiene and water sanitation, food systems and the home environment. Ethics and dissemination This study has been approved by the relevant Ethics Committees in Indonesia, India and Senegal, and the UK. Research data will be published and posted in public repositories.

Original languageEnglish
Article numbere001770
JournalBMJ Paediatrics Open
Issue numberSuppl 1
Publication statusPublished - 27 Feb 2024


  • Data Collection
  • Genetics
  • Growth


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