Knowledge about the Developmental Origins of Health and Disease is independently associated with variation in diet quality during pregnancy.

Beth Murray‐Davis,Meghan McConnell,Sarah D. McDonald,Deborah M. Sloboda,Tina Moffat,Stephanie A. Atkinson,Luseadra McKerracher,Mary Barker

doi:10.1111/mcn.12891

Abstract

Environmental factors affecting development through embryogenesis, pregnancy, and infancy impact health through all subsequent stages of life. Known as the Developmental Origins of Health and Disease (DOHaD) hypothesis, this concept is widely accepted among health and social scientists. However, it is unclear whether DOHaD‐based ideas are reaching the general public and/or influencing behaviour. This study thus investigated whether and under what circumstances pregnant people in Canada are familiar with DOHaD, and if DOHaD familiarity relates to eating behaviour. Survey responses from pregnant people from Hamilton, Canada, were used to assess respondents' knowledge of DOHaD (hereafter, DOHaDKNOWLEDGE) compared with their knowledge of more general pregnancy health recommendations (Pregnancy GuidelineKNOWLEDGE). The survey also characterized respondents' pregnancy diet quality and sociodemographic profiles. We fit two multiple, linear, mixed regression models to the data, one with DOHaDKNOWLEDGE score as the dependent variable and the other with diet quality score as the dependent. In both models, responses were clustered by respondents' neighbourhoods. Complete, internally consistent responses were available for 330 study‐eligible respondents. Relative to Pregnancy GuidelineKNOWLEDGE, respondents had lower, more variable DOHaDKNOWLEDGE scores. Additionally, higher DOHaDKNOWLEDGE was associated with higher socio‐economic position, older age, and lower parity, independent of Pregnancy GuidelineKNOWLEDGE. Diet quality during pregnancy was positively associated with DOHaDKNOWLEDGE, adjusting for sociodemographic factors. A subset of relatively high socio‐economic position respondents was familiar with DOHaD. Greater familiarity with DOHaD was associated with better pregnancy diet quality, hinting that translating DOHaD knowledge to pregnant people may motivate improved pregnancy nutrition and thus later‐life health for developing babies.

Highlights

Non-communicable diseases (NCDs) related to obesity and metabolic function represent leading causes of illness and death globally (World Health Organization, 2017)
Internally consistent responses to all questions used to assess DOHaDKNOWLEDGE, Pregnancy GuidelineKNOWLEDGE, diet quality, respondent's age, socio-economic position (SEP) score, parity, and status as a newcomer to Canada were available from 330 respondents, inclusive of the 78 respondents to the pilot
We developed and used a novel instrument to show that most respondents were very knowledgeable about general pregnancy health recommendations as laid out by Health Canada (Pregnancy GuidelineKNOWLEDGE), but strikingly few respondents, by comparison, were knowledgeable about Developmental Origins of Health and Disease (DOHaD) concepts (DOHaDKNOWLEDGE)

Summary

Introduction

Non-communicable diseases (NCDs) related to obesity and metabolic function (e.g., cardiovascular disease and type 2 diabetes mellitus) represent leading causes of illness and death globally (World Health Organization, 2017). These diseases manifest mainly in adulthood, abundant evidence indicates that the main risk factors for metabolism-related NCDs are established during the peri-conceptional and foetal stages of development (Barker et al, 2017; Fleming et al, 2018; Stephenson et al, 2018). Models derived from the DOHaD hypothesis indicate that strategies for reducing the burden of metabolic disease should focus on intervening in the earliest stages of life (Garmendia, Corvalan, & Uauy, 2014; Godfrey et al, 2017; Hanson & Gluckman, 2015; Low, Gluckman, & Hanson, 2018; Stephenson et al, 2018; Victora et al, 2016). Over the last decade, there has been an increasing push to translate key findings from DOHaD-related research into social and public health policy and guidelines as well as into clinical practice (Anon., 2011; Barker et al, 2017; Mckerracher, Moffat, Barker, Williams, & Sloboda, 2019)

Results

Discussion

Conclusion