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Developmental Origins of Health and Disease (DOHaD): Implications for Health Policy and Health Promotion

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A special issue of Healthcare (ISSN 2227-9032).

Deadline for manuscript submissions: closed (30 May 2016) | Viewed by 113343

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Prof. Lawrence Wallack

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Professor of Public Health & Director, Center for Public Health Studies, College of Urban & Public Affairs, Portland State University, Portland, OR 97201, USA
Interests: social determinants of health; health inequality; health equity; developmental origins of health and disease; role of government; media advocacy; low birthweight; framing public health issues

Special Issue Information

Dear Colleagues,

The purpose of this issue is to explore the implications for public health policy and health promotion/prevention programs of the rapidly expanding knowledge base of the developmental origins of health and disease (DOHaD). This new science fundamentally changes our understanding of the roots of significant chronic disease such as heart disease, stroke, diabetes, and obesity.We now know that intergenerational vulnerability for disease is established prior to and in the first 1000 days after conception. Vulnerability for virtually all chronic diseases, several cancers, and significant mental health problems, are now linked to this critical interval. In addition, cognitive development, as assessed by readiness for school measures, is also established during this period. Understanding disease as a product of a gene-environment interaction and not just a function of genes-plus-behavior, represents the bridging of nature and nurture. This redefines the idea of “upstream” and presents new challenges and opportunities for how we think about policy and program related to health promotion and broader prevention. This issue will be one of the first opportunities to engage in professional discourse on this issue.

Prof. Lawrence Wallack
Guest Editor

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Keywords

developmental origins of health and disease
Barker Hypothesis
social determinants of health
developmental plasticity
low birthweight
First Thousand Days
epigenetics
prevention
health promotion

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Published Papers (10 papers)

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Research

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201 KiB

Open AccessArticle

Reducing Low Birth Weight among African Americans in the Midwest: A Look at How Faith-Based Organizations Are Poised to Inform and Influence Health Communication on the Developmental Origins of Health and Disease (DOHaD)

by Crystal Y. Lumpkins and Jarron M. Saint Onge

Healthcare 2017, 5(1), 6; https://doi.org/10.3390/healthcare5010006 - 4 Feb 2017

Cited by 7 | Viewed by 6268

Abstract

Low birth weight (LBW) rates remain the highest among African Americans despite public health efforts to address these disparities; with some of the highest racial disparities in the Midwest (Kansas). The Developmental Origins of Health and Disease (DOHaD) perspective offers an explanation for how LBW contributes to racial health disparities among African Americans and informs a community directed health communication framework for creating sustainable programs to address these disparities. Trusted community organizations such as faith-based organizations are well situated to explain health communication gaps that may occur over the life course. These entities are underutilized in core health promotion programming targeting underserved populations and can prove essential for addressing developmental origins of LBW among African Americans. Extrapolating from focus group data collected from African American church populations as part of a social marketing health promotion project on cancer prevention, we theoretically consider how a similar communication framework and approach may apply to address LBW disparities. Stratified focus groups (n = 9) were used to discover emergent themes about disease prevention, and subsequently applied to explore how faith-based organizations (FBOs) inform strategic health care (media) advocacy and health promotion that potentially apply to address LBW among African Americans. We argue that FBOs are poised to meet health promotion and health communication needs among African American women who face social barriers in health. Full article

(This article belongs to the Special Issue Developmental Origins of Health and Disease (DOHaD): Implications for Health Policy and Health Promotion)

232 KiB

Open AccessArticle

Intersystem Implications of the Developmental Origins of Health and Disease: Advancing Health Promotion in the 21st Century

by Michael D. Barnes, Thomas L. Heaton, Michael C. Goates and Justin M. Packer

Healthcare 2016, 4(3), 45; https://doi.org/10.3390/healthcare4030045 - 15 Jul 2016

Cited by 23 | Viewed by 6831

Abstract

The developmental origins of health and disease (DOHaD) theory and life course theory (LCT) are emerging fields of research that have significant implications for the public health and health promotion professions. Using a DOHaD/LCT perspective, social determinants of health (SDH) take on new critical meaning by which health promotion professionals can implement DOHaD/LCT guided interventions, including recommended policies. Through these interventions, public health could further address the sources of worldwide chronic disease epidemics and reduce such disease rates substantially if related policy, programs, and interdisciplinary and multi-sector collaboration are emphasized. Additional characteristics of the most effective interventions involve context-specific adaptation and societal structures that impact upstream, early life environments on a broad scale, influencing multiple locations and/or diseases. Full article

(This article belongs to the Special Issue Developmental Origins of Health and Disease (DOHaD): Implications for Health Policy and Health Promotion)

Review

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413 KiB

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Developmental Origins of Health and Disease: A Lifecourse Approach to the Prevention of Non-Communicable Diseases

by Janis Baird, Chandni Jacob, Mary Barker, Caroline H. D. Fall, Mark Hanson, Nicholas C. Harvey, Hazel M. Inskip, Kalyanaraman Kumaran and Cyrus Cooper

Healthcare 2017, 5(1), 14; https://doi.org/10.3390/healthcare5010014 - 8 Mar 2017

Cited by 139 | Viewed by 18378

Abstract

Non-communicable diseases (NCDs), such as cardiovascular disease and osteoporosis, affect individuals in all countries worldwide. Given the very high worldwide prevalence of NCDs across a range of human pathology, it is clear that traditional approaches targeting those at most risk in older adulthood will not efficiently ameliorate this growing burden. It will thus be essential to robustly identify determinants of NCDs across the entire lifecourse and, subsequently, appropriate interventions at every stage to reduce an individual’s risk of developing these conditions. A lifecourse approach has the potential to prevent NCDs, from before conception through fetal life, infancy, childhood, adolescence, adulthood and into older age. In this paper, we describe the origins of the lifecourse concept, the importance of early life influences, for example during pregnancy, examine potential underlying mechanisms in both cell biology and behavior change, and finally describe current efforts to develop interventions that take a lifecourse approach to NCD prevention. Two principal approaches to improving women’s nutritional status are outlined: nutritional supplementation and behavior change. Full article

(This article belongs to the Special Issue Developmental Origins of Health and Disease (DOHaD): Implications for Health Policy and Health Promotion)

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192 KiB

Open AccessReview

The Implications of the Developmental Origins of Health and Disease on Public Health Policy and Health Promotion in South Africa

by Sasiragha Priscilla Reddy and Anthony David Mbewu

Healthcare 2016, 4(4), 83; https://doi.org/10.3390/healthcare4040083 - 9 Nov 2016

Cited by 6 | Viewed by 5196

Abstract

The developmental origins of health and disease (DOHaD) hypothesis states that environmental influences in utero and in early life can determine health and disease in later life through the programming of genes and/or altered gene expression. The DOHaD is likely to have had an effect in South Africa during the fifty years of apartheid; and during the twenty years since the dawn of democracy in 1994. This has profound implications for public health and health promotion policies in South Africa, a country experiencing increased prevalence of noncommunicable diseases (NCDs) and risk factors and behaviours for NCDs due to rapid social and economic transition, and because of the DOHaD. Public health policy and health promotion interventions, such as those introduced by the South African Government over the past 20 years, were designed to improve the health of pregnant women (and their unborn children). They could in addition, through the DOHaD mechanism, reduce NCDs and their risk factors in their offspring in later life. The quality of public health data over the past 40 years in South Africa precludes the possibility of proving the DOHaD hypothesis in that context. Nevertheless, public health and health promotion policies need to be strengthened, if South Africa and other low and middle income countries (LMICs) are to avoid the very high prevalence of NCDs seen in Europe and North America in the 50 years following the Second World War, as a result of socio economic transition and the DOHaD. Full article

(This article belongs to the Special Issue Developmental Origins of Health and Disease (DOHaD): Implications for Health Policy and Health Promotion)

1088 KiB

Open AccessReview

Realizing the Potential of Adolescence to Prevent Transgenerational Conditioning of Noncommunicable Disease Risk: Multi-Sectoral Design Frameworks

by Jacquie L. Bay, Susan M. Morton and Mark H. Vickers

Healthcare 2016, 4(3), 39; https://doi.org/10.3390/healthcare4030039 - 4 Jul 2016

Cited by 29 | Viewed by 8951

Abstract

Evidence from the field of Developmental Origins of Health and Disease (DOHaD) demonstrates that early life environmental exposures impact later-life risk of non-communicable diseases (NCDs). This has revealed the transgenerational nature of NCD risk, thus demonstrating that interventions to improve environmental exposures during early life offer important potential for primary prevention of DOHaD-related NCDs. Based on this evidence, the prospect of multi-sectoral approaches to enable primary NCD risk reduction has been highlighted in major international reports. It is agreed that pregnancy, lactation and early childhood offer significant intervention opportunities. However, the importance of interventions that establish positive behaviors impacting nutritional and non-nutritional environmental exposures in the pre-conceptual period in both males and females, thus capturing the full potential of DOHaD, must not be overlooked. Adolescence, a period where life-long health-related behaviors are established, is therefore an important life-stage for DOHaD-informed intervention. DOHaD evidence underpinning this potential is well documented. However, there is a gap in the literature with respect to combined application of theoretical evidence from science, education and public health to inform intervention design. This paper addresses this gap, presenting a review of evidence informing theoretical frameworks for adolescent DOHaD interventions that is accessible collectively to all relevant sectors. Full article

(This article belongs to the Special Issue Developmental Origins of Health and Disease (DOHaD): Implications for Health Policy and Health Promotion)

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370 KiB

Open AccessReview

Population Health and Paid Parental Leave: What the United States Can Learn from Two Decades of Research

by Adam Burtle and Stephen Bezruchka

Healthcare 2016, 4(2), 30; https://doi.org/10.3390/healthcare4020030 - 1 Jun 2016

Cited by 71 | Viewed by 27697

Abstract

Over the last two decades, numerous studies have suggested that dedicated time for parents to be with their children in the earliest months of life offers significant benefits to child health. The United States (US) is the only wealthy nation without a formalized policy guaranteeing workers paid time off when they become new parents. As individual US states consider enacting parental leave policies, there is a significant opportunity to decrease health inequities and build a healthier American population. This document is intended as a critical review of the present evidence for the association between paid parental leave and population health. Full article

(This article belongs to the Special Issue Developmental Origins of Health and Disease (DOHaD): Implications for Health Policy and Health Promotion)

125 KiB

Open AccessReview

Perinatal Maternal Mental Health, Fetal Programming and Child Development

by Andrew J. Lewis, Emma Austin, Rebecca Knapp, Tina Vaiano and Megan Galbally

Healthcare 2015, 3(4), 1212-1227; https://doi.org/10.3390/healthcare3041212 - 26 Nov 2015

Cited by 66 | Viewed by 14567

Abstract

Maternal mental disorders over pregnancy show a clear influence on child development. This review is focused on the possible mechanisms by which maternal mental disorders influence fetal development via programming effects. This field is complex since mental health symptoms during pregnancy vary in type, timing and severity and maternal psychological distress is often accompanied by higher rates of smoking, alcohol use, poor diet and lifestyle. Studies are now beginning to examine fetal programming mechanisms, originally identified within the DOHaD framework, to examine how maternal mental disorders impact fetal development. Such mechanisms include hormonal priming effects such as elevated maternal glucocorticoids, alteration of placental function and perfusion, and epigenetic mechanisms. To date, mostly high prevalence mental disorders such as depression and anxiety have been investigated, but few studies employ diagnostic measures, and there is very little research examining the impact of maternal mental disorders such as schizophrenia, bipolar disorder, eating disorders and personality disorders on fetal development. The next wave of longitudinal studies need to focus on specific hypotheses driven by plausible biological mechanisms for fetal programming and follow children for a sufficient period in order to examine the early manifestations of developmental vulnerability. Intervention studies can then be targeted to altering these mechanisms of intergenerational transmission once identified. Full article

(This article belongs to the Special Issue Developmental Origins of Health and Disease (DOHaD): Implications for Health Policy and Health Promotion)

Other

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486 KiB

Open AccessEssay

Translating Developmental Origins: Improving the Health of Women and Their Children Using a Sustainable Approach to Behaviour Change

by Mary Barker, Janis Baird, Tannaze Tinati, Christina Vogel, Sofia Strömmer, Taylor Rose, Rufia Begum, Megan Jarman, Jenny Davies, Sue Thompson, Liz Taylor, Hazel Inskip, Cyrus Cooper, Don Nutbeam and Wendy Lawrence

Healthcare 2017, 5(1), 17; https://doi.org/10.3390/healthcare5010017 - 20 Mar 2017

Cited by 10 | Viewed by 7633

Abstract

Theories of the developmental origins of health and disease imply that optimising the growth and development of babies is an essential route to improving the health of populations. A key factor in the growth of babies is the nutritional status of their mothers. Since women from more disadvantaged backgrounds have poorer quality diets and the worst pregnancy outcomes, they need to be a particular focus. The behavioural sciences have made a substantial contribution to the development of interventions to support dietary changes in disadvantaged women. Translation of such interventions into routine practice is an ideal that is rarely achieved, however. This paper illustrates how re-orientating health and social care services towards an empowerment approach to behaviour change might underpin a new developmental focus to improving long-term health, using learning from a community-based intervention to improve the diets and lifestyles of disadvantaged women. The Southampton Initiative for Health aimed to improve the diets and lifestyles of women of child-bearing age through training health and social care practitioners in skills to support behaviour change. Analysis illustrates the necessary steps in mounting such an intervention: building trust; matching agendas and changing culture. The Southampton Initiative for Health demonstrates that developing sustainable; workable interventions and effective community partnerships; requires commitment beginning long before intervention delivery but is key to the translation of developmental origins research into improvements in human health. Full article

(This article belongs to the Special Issue Developmental Origins of Health and Disease (DOHaD): Implications for Health Policy and Health Promotion)

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268 KiB

Open AccessCommentary

Promoting Healthy Growth or Feeding Obesity? The Need for Evidence-Based Oversight of Infant Nutritional Supplement Claims

by Michelle Lampl, Amanda Mummert and Meriah Schoen

Healthcare 2016, 4(4), 84; https://doi.org/10.3390/healthcare4040084 - 12 Nov 2016

Cited by 10 | Viewed by 8039

Abstract

The Developmental Origins of Health and Disease (DOHaD) model recognizes growth in infancy and childhood as a fundamental determinant of lifespan health. Evidence of long-term health risks among small neonates who subsequently grow rapidly poses a challenge for interventions aiming to support healthy growth, not merely drive weight gain. Defining healthy growth beyond “getting bigger” is essential as infant and young child feeding industries expand. Liquid-based nutritional supplements, originally formulated for undernourished children, are increasingly marketed for and consumed by children generally. Clarifying the nature of the evidentiary base on which structure/function claims promoting “healthy growth” are constructed is important to curb invalid generalizations. Evidence points to changing social beliefs and cultural practices surrounding supplementary feeding, raising specific concerns about the long-term health consequences of an associated altered feeding culture, including reduced dietary variety and weight gain. Reassessing the evidence for and relevance of dietary supplements’ “promoting healthy growth” claims for otherwise healthy children is both needed in a time of global obesity and an opportunity to refine intervention approaches among small children for whom rapid subsequent growth in early life augments risk for chronic disease. Scientific and health care partnerships are needed to consider current governmental oversight shortfalls in protecting vulnerable populations from overconsumption. This is important because we may be doing more harm than good. Full article

(This article belongs to the Special Issue Developmental Origins of Health and Disease (DOHaD): Implications for Health Policy and Health Promotion)

228 KiB

Open AccessCommentary

From Embryos to Adults: A DOHaD Perspective on In Vitro Fertilization and Other Assisted Reproductive Technologies

by Sky Feuer and Paolo Rinaudo

Healthcare 2016, 4(3), 51; https://doi.org/10.3390/healthcare4030051 - 9 Aug 2016

Cited by 38 | Viewed by 6822

Abstract

Human in vitro fertilization (IVF) as a treatment for infertility is regarded as one of the most outstanding accomplishments of the 20th century, and its use has grown dramatically since the late 1970s. Although IVF is considered safe and the majority of children appear healthy, reproductive technologies have been viewed with some skepticism since the in vitro environment deviates substantially from that in vivo. This is increasingly significant because the Developmental Origins of Health and Disease (DOHaD) hypothesis has illuminated the sensitivity of an organism to its environment at critical stages during development, including how suboptimal exposures restricted specifically to gamete maturation or the preimplantation period can affect postnatal growth, glucose metabolism, fat deposition, and vascular function. Today, some of the physiological metabolic phenotypes present in animal models of IVF have begun to emerge in human IVF children, but it remains unclear whether or not in vitro embryo manipulation will have lasting health consequences in the offspring. Our expanding knowledge of the DOHaD field is fueling a paradigm shift in how disease susceptibility is viewed across the life course, with particular emphasis on the importance of collecting detailed exposure information, identifying biomarkers of health, and performing longitudinal studies for any medical treatment occurring during a developmentally vulnerable period. As IVF use continues to rise, it will be highly valuable to incorporate DOHaD concepts into the clinical arena and future approaches to public health policy. Full article

(This article belongs to the Special Issue Developmental Origins of Health and Disease (DOHaD): Implications for Health Policy and Health Promotion)

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