Finnish Health and Early Life Microbiota (HELMi)

HELMi (Health and Early Life Microbiota) is a longitudinal, prospective general population birth cohort, set up to identify environmental, lifestyle and genetic factors that modify the intestinal microbiota development in the first years of life, and their relation to the child health and well-being.

Awareness of the potential long-term consequences of the early life gut microbiota development is individual health is increasing, and accumulating evidence indicates a key role for the early gut microbiome in the Developmental Origins of Health and Disease (DOHaD).

The HELMi cohort consists of 1055 healthy term infants born in 2016-2018 mainly at the capital region of Finland, and their parents. The cohort is currently being followed up from pregnancy until 2 years of age, and at 4-5 years. Birth mode, nutrition, and antibiotic intake all are known to affect the development of early life microbiota. Our goal is to broaden the understanding of how families’ lifestyle and care practices as well as the clinical practices e.g. regarding antenatal antibiotic prophylaxis affect the child’s microbiota development. In addition, we study the impact of these exposures and early microbiota features on growth, gastrointestinal and overall health as well as development of diseases, such as allergies.

Early microbiota development is analysed based on frequent fecal sampling from the child (9 samples during 0-24 months). Additionally, parental fecal samples, breast milk samples from the lactating mother and DNA sample from the child have been collected. Extensive metadata from both the child and the parents were collected using electronic questionnaires at weekly to monthly intervals for the first two years to record e.g. nutrition, crying, sleep as well as indoor and outdoor environmental exposures. Illnesses, medication and supplements were recorded continuously. National health care and drug purchase registries will be utilized for objective assessment of the clinical diagnoses and purchase of antibiotics and other drugs that are available only via prescriptions. Child’s cognitive, social and motor development is assessed with standardized questionnaires and additionally the majority of the children underwent cognitive test performed by a psychologist.

At 4-5 year follow up organized in 2020-2022 entailed re-sampling of stools for the child and the parents with extensive questionnaires on gut and overall health, diet etc. Children’s body composition was measured and blood samples were taken for determination of lipids.

Being most sensitive to environmental stimuli and most influential on the host physiology, the early microbiota is attainable target to reduce the risk of later disease. We utilize e.g. metagenomic and amplicon sequencing of the intestinal microbiota samples, human milk oligosaccharide profiling of the breastmilk samples, and culture-based isolation, genomic and phenotypic characterization of the early life colonizers. By analyzing and integrating different omics and other data our project will provide fundamental understanding on how infants’ microbiota develop, forming a basis for predicting and (re)directing it to support healthy development and future.

Trial registration number NCT03996304

The cohort profile article has been published in 2019 and the first original publications on the HELMi cohort can be found in our group's publications.

Principal investigators: Docent Anne Salonen and Professor Willem de Vos, Human Microbiome Research Program, Faculty of Medicine, University of Helsinki, Finland

Responsible MD: Professor Kaija-Leena Kolho, University of Helsinki, Finland

Contacts: Scientific matters:

General matters:

Funding: Main funders are Business Finland, Academy of Finland and H2020-MSCA-ITN-2018 grant 8144102. Also the Paulo Foundation, Päivikki ja Sakari Sohlberg Foundation, Biocodex Microbiota Foundation, Mary and Geor Ehnrooth Foundation, and Foundation for Nutrition Research grant are acknowledged for support.