1. DOHaD and ORIGINS Flashcards
What is a non-communicable disease (NCD) and what is its relevance?
- NCDs are chronic inflammatory diseases that can appear in virtually all organ systems are a cure is rarely achieved.
- All NCDs are dramatically increasing in modern society with 60% of deaths due to NCDS and 80% of those in underprivileged countries.
- Significant risk factors in early life which we are just looking into
what are the big 4 NCDs and the big 4 risk factors
NCDs
- Type 2 diabetes
- heart disease
- chronic obstructive pulmonary disease
- cancer
Risk factors
- Poor nutrition
- smoking
- alcohol
-physical activity
What are some more modern (maternal) risk factors and why are these risk factors?
Maternal age
maternal health
maternal nutrition
These are risk factors because environmental exposures such as smoking leave epigenetic markers which are transferred through the germline to subsequent generations.
* Eg grandmothers who smoked during pregnancy are more likely to have grandchildren with 2x the risk of asthma
The barker hypothesis (1980)
- Impaired fetal growth and nutrition might be linked to variations in congenital heart defects
- Found this to be true in a Hertfordshire cohort where low birthweight at 1 year or birth increased the risk of CHD in 5654 men
What does low birth weight indicate and why is it a factor for NCDs
- Low birth rate indicates a suboptimal in-utero environment
- This means we develop physiologic adaptions for predicted scarcity in the postnatal environment
- When this is mismatched with the actual environment (ie overabundance of food) children are at greater risk for developing adult obesity, inflammation and NCD
Maternal obesity and its risks
- 50% of mothers in pregnancy are either overweight or obese
- 72% of fathers are too
- a chronic inflammatory state1 with effects on fetal programming
- Higher CRP in offspring (12 years)1, Obesity, CVD, diabetes2, Asthma and lung disease3,
Factors that have effects on developing fetus
- More sugar & fatty foods, Less fibre, Less n-3PUFA & fresh food
- Obesity/smoking/alcohol
- Less microbial diversity
- Less physical activity, Less time outside
- More modern pollutants and smoking
- More stress
What is the microbiome and what does that mean and what effects it?
- The human microbiome is the aggregate of all microbiota that reside on or within human tissues and biofluids
- We are 10% human genes
- 90% bacterial genes which means they constantly changing
- What we eat, antibiotic use, and time outside all affect our immune system and brain development
Environmental Microbes:
- M. vaccae and Lactobacillus plantarum
- Reduces blood pressure and stress
Urban vs rural adults have different microbiota
What does transplanting bacteria do?
- changes the microbiome
- In animals changing gut bacteria can change:
- weight gain, brain and immune development, heart disease, diabetes risk and longevity.
- Bacteria from lean vs obese person transplanted into a mouse.
Terms of gestation
- Late pre-term 34-36 weeks
- Early term 37-38 weeks
- Term 39+ weeks
- Post Term 42+ weeks
Consequences of early-term babies
- Higher risk of behavioural problems1 and ADHD2 if delivered at 37 weeks compared with 38+ weeks.
- Higher levels of educational special needs for early babies (24 weeks) lots of special attention needed, still great variation between 34 to 39 weeks
Screen time facts and effects
- 9 % Australian infants (0- 2yrs) own a smart phone
- 2 Hours/day Australian infants use screens
- 33 % Australian preschoolers (3-5yrs) own a tablet
- 4 Hours/day Australian preschoolers use screens
- Usually watch alone and has negative effects on attachment
- > 2hr/d : 6x risk of language disorder
- reduced working memory/hour screen time
- Significantly Media exposure < 6mts: lower cognitive and language scores 14mts
- Roaming distance difference of back in they day compare to know makes kids more anxious
