Developmental Origins

Developmental Origins of Health and Disease

The dramatic environmental and lifestyle changes of the modern age pose a significant threat to human health.

An unparalleled rise in global burden of a diverse range of chronic non-communicable diseases (NCDs) worldwide is one of the major challenges of the 21st century.

The most common NCDs include: cardiovascular disease, obesity, diabetes, asthma and chronic respiratory disease, allergies and autoimmunity, arthritis, mental ill-health, neurological and neurodegenerative disorders.

It is becoming increasingly evident that an individual's lifetime health and disease may be programmed at a very early stage.

This concept is known as the Developmental Origins of Health and Disease (DOHaD).

History of DOHaD

The Developmental Origins of Health and Disease (DOHaD) concept describes how maternal and environmental factors during a child's life, right from conception, can affect that child's growth and development.

The DOHaD Consortium exists to promote inter-disciplinary research in order to prevent the rising global burden of non-communicable diseases (NCDs). The Consortium seeks to understand and characterise 'pathways of risk' on multiple levels ranging from a societal level to a molecular level. Based at The University of Western Australia (UWA), the DOHaD Consortium brings together a broad range of world-class experts investigating the 'early life origins of disease' across multiple disciplines and fields of medicine. All groups bring their own national and international collaborators generating links to an enormous global network of researchers investigating early life origins and prevention of NCDs.

UWA is also a prominent member of the World Universities Network (WUN), which established the 'WUN Early Life Opportunities for the Prevention of NCD in Developing Countries' as a new Global Challenge in 2011. Members of the DOHaD Consortium representing UWA played an active role in the development of the Shanghai Declaration promoting the importance of early life interventions in the prevention of NCDs, and continue to interact through this important forum. Focused research networks are also being developed though WUN (and beyond) through the specific thematic research clusters which are geared around particular NCD challenges.

All modern diseases are associated with modern lifestyle changes, suggesting common risk factors for many NCDs. These risks include unhealthy dietary patterns, reduced physical activity, altered patterns of microbial exposure, tobacco smoking, harmful use of alcohol, and other environmental pollutants.

Prevention is the ultimate approach to reducing the burden of NCDs. The greatest potential for success lies in early life and there is already substantial evidence that initiatives to promote a 'healthy start to life' can reduce the risk of both early and later NCDs with wide social and economic benefits. The early environment (pre-pregnancy and during early childhood) can modify physiological, structural, immune, metabolic, and behavioural response patterns to influence disease susceptibility.

Origins by Dr Susan Prescott

Origins: Early-life solutions to the modern health crisis

The field of epigenetics is revolutionising our understanding of how environment shapes our genes. Dr Susan Prescott, a leading childhood immunologist, shows how the application of epigenetics through Developmental Origins of Health and Disease (DOHaD) is changing scientific research and public health.

A poor start to life is associated with an increased risk of disorders throughout life, including cardiovascular disease, obesity, type 2 diabetes and metabolic disturbances, osteoporosis, chronic obstructive lung disease, some forms of cancer and some mental illnesses. The environment in which early life develops - at conception, and/or during fetal life, infancy and early childhood - induces changes in development that have a long term impact on later health and disease risk. Parental lifestyle and diet, smoking, obesity and exposure to endocrine disruptor chemicals and toxins, have all been shown to modulate disease risk. The effects of such exposures are often graded and subtle - they do not simply disrupt development or induce disease themselves - but can affect how rapidly disease develops in an individual. However, timely interventions may reduce such risk in individuals and also limit its transmission to the next generation.

DOHaD has significant implications for many societies and for global health policy. In Origins, Dr Prescott explains the research and shows how a focus on early life in health promotion, the exchange of knowledge between policymakers, clinical and basic scientists and the wider public, and education and training, will build capacity to assist a healthy start to life across populations.

Origins is available from:
UWA Publishing
Amazon