Abstract
Obesity and its related non-communicable diseases (NCDs), such as type 2 diabetes, heart disease and cancer, impose huge burdens on society, particularly the healthcare system. Until recently, public health and policy were primarily focused on secondary prevention and treatment of NCDs. However, epidemiological and experimental evidence indicates that early-life exposures influence the risk of childhood obesity and related diseases later in life, and has now focused attention on the health of both mother and child. During pregnancy and the early neonatal period, individuals respond to their environment by establishing anatomical, physiological and biochemical trajectories that shape their future health. This period of developmental plasticity provides an early window of opportunity to mitigate the environmental insults that may increase an individual's sensitivity to, or risk of, developing obesity or related diseases later in life. Although much investigation has already occurred in the area of Developmental Origins of Health and Disease research, the science itself is still in its infancy. It remains for researchers to tackle the important outstanding questions and translate their knowledge into workable solutions for the public good. The challenge, however, is to decide which areas to focus on. With these opportunities and challenges in mind, the 2014 Gravida Summit convened to examine how its early-life research program can determine which areas of research into mechanisms, biomarkers and interventions could contribute to the international research strategy to fight childhood obesity and its related diseases.
Highlights
Global rates of overweight and obesity and their related health conditions have increased rapidly over the last 30 years[1] and impose large burdens on public health systems, the economy and society.[2]
There is increasing evidence that influences during early life are inextricably linked to the later development of obesity and related non-communicable diseases (NCDs), such as type 2 diabetes, hypertension, heart disease and many cancers.[4,5,6,7,8]
It is undisputed that obesity and related NCDs place a large burden on the public health system, economy and society in New Zealand.[77]
Summary
Global rates of overweight and obesity and their related health conditions have increased rapidly over the last 30 years[1] and impose large burdens on public health systems, the economy and society.[2]. Establishing a ‘chain of evidence’ is critical for understanding how an early-life environmental insult may cause a stable molecular change (e.g. epigenetic) to be established and maintained in the genome that subsequently leads to a phenotypic consequence (Recommendation 3, Table 1) In humans, this requires the establishment of cohort studies with extensive environmental exposure information and longitudinally sampled biospecimens. The range of models and species used, different windows of exposure to either the initial environmental insult or the treatment/mode of intervention, and incomplete reporting of animal numbers and outcomes make assessment of bias very difficult.[66] it is well established that a wide range of early-life insults can lead to increased risk of later obesity and NCD phenotypes, closer alignment of animal models where possible would make pathways to mechanistic insights and efficacy of treatment modalities more effective.
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