Open Access Open Badges Study protocol

Rationale and design of South Asian Birth Cohort (START): a Canada-India collaborative study

Sonia S Anand123*, Anil Vasudevan5, Milan Gupta14, Katherine Morrison13, Anura Kurpad5, Koon K Teo13, Krishnamachari Srinivasan5 and The START Cohort Study Investigators

Author Affiliations

1 McMaster University, 1280 Main St West MDCL 3200, L8S 4K1, Hamilton, ON, Canada

2 Population Genomics Program, Chanchlani Research Centre, McMaster University, Hamilton, Canada

3 Population Health Research Institute, Hamilton Health Sciences and McMaster University, Hamilton, Canada

4 Canadian Cardiovascular Research Network, Brampton, Ontario

5 St John’s Research Institute and St. John’s Medical College, Bangalore, India

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BMC Public Health 2013, 13:79  doi:10.1186/1471-2458-13-79

Published: 28 January 2013



People who originate from the Indian subcontinent (South Asians) suffer among the highest rates of type 2 diabetes in the world. Prior evidence suggests that metabolic risk factors develop early in life and are influenced by maternal and paternal behaviors, the intrauterine environment, and genetic factors. The South Asian Birth Cohort Study (START) will investigate the environmental and genetic basis of adiposity among 750 South Asian offspring recruited from highly divergent environments, namely, rural and urban India and urban Canada.


Detailed information on health behaviors including diet and physical activity, and blood samples for metabolic parameters and DNA are collected from pregnant women of South Asian ancestry who are free of significant chronic disease. They also undergo a provocative test to diagnose impaired glucose tolerance and gestational diabetes. At delivery, cord blood and newborn anthropometric indices (i.e. birth weight, length, head circumference and skin fold thickness) are collected. The mother and growing offspring are followed prospectively and information on the growth trajectory, adiposity and health behaviors will be collected annually up to age 3 years. Our aim is to recruit a minimum of 750 mother-infant pairs equally divided between three divergent environments: rural India, urban India, and Canada.


The START cohort will increase our understanding of the environmental and genetic determinants of adiposity and related metabolic abnormalities among South Asians living in India and Canada.

Birth cohort; South Asian; Adiposity; Insulin resistance; Early origins; India; Canada