49. Health Across the Life Course Flashcards
What is the Barker hypothesis?
What is the conflicting social epidemiology view?
IUGR, LBW and premature birth have a causal relationship to the origins of hypertension, coronary heart disease, and non-insulin dependant diabetes, in adulthood.
Effect of childhood socio-economic status is additional to the effect of adult risk factors and SES. Socially patterned exposures in childhood have important influences on adult health and chronic diseases.
Describe the significance of the following Birth Cohort Studies:
a) Born in Bradford
b) ALSPAC
c) 1946 birth cohort
a) cohort of 13,500 children born in a Bradford hospital, health tracked from pregnancy into adulthood. Info used to find causes of common childhood illnesses and explore mental/social development.
b) Avon longitudinal study of parents and children - established to understand how genetic and environmental characteristics influence health and development in parents and children. All pregnant women in SW England with an expected delivery date in a set period were recruited and followed over the last 19-22y.
c) from initial maternity survey of 13,687 births during one march week in 1946 - 5,362 singleton babies were selected for followup. Main aim during childhood was to investigate how home and school environment affected physical and mental development and educational attainment.
What did the ‘‘Dutch Famine” show?
What is ‘health capital’?
How can ‘health capital’ be improved?
Prenatal exposure to famine, especially during late gestataion, is linked to decreased glucose tolerence in adults. May lead to permanent changes in insulin-glucose metabolism.
Individual’s capacity for health across the life course. Stock of biological reserves which children accumulate as they grow and underpin health in adulthood.
Start from pregnancy and breastfeeding, education and lifestyle choices (physical activity, diet), social relationships (social networks linked to better health through social capital).
What are epigenetics? Give one mechanism.
How might environmental conditions affect insulin-like growth factor II?
Heritable changes in gene expression not explained by DNA sequence. One mechanism is altered DNA methylation (increased methylation switches gene off and vice versa).
One epigenetically regulated loci is IGF2 - a key factor in growth. IGF2 differentially methylated region (DMR) methylation is a normally distributed quantitative trait largely determined genetically in adolescence and middle age, but if affected by environmental conditions early in development, altered IGF2 DMR methylation may be detected many years later. Ex: exposure to famine during the Dutch Hunger Winter is associated with lower methylation of IGF2 DMR 6 decades later.
