Age + Dev - Impacts of Environment Flashcards
What challenges would the foetus face in utero that could impact its long-term health?
- Fetal infection in utero
- Maternal nutrition
- Maternal illness
- Maternal stress
- Maternal medication
- Environmental factors/exposures
What are the biological influences on long term health + risk of disease?
- Genetics
* Epigenetics
What are the social + environmental influences on long-term health?
- Environment
- Family, Neighbourhood, School
- Nutrition (maternal and fetal/child)
- Social - behaviours seen – substance use, care giver behaviour
- Health Provisions
What is the DOHaD or Barker hypothesis?
- Developmental Origins of Health + Disease (DOHaD)
- adverse nutrition in early life, including prenatally as measured by birth weight, increased susceptibility to the metabolic syndrome which includes obesity, diabetes, insulin insensitivity, hypertension, and hyperlipidemia and complications that include coronary heart disease
What were the conclusions found by a study into Barker hypothesis?
- On average, adults who had a coronary event had been small at birth and thin at two years of age
- Thereafter put on weight rapidly.
- The risk of coronary events was more strongly related to the rate of change of childhood BMI, rather than to the BMI attained at any particular age of childhood.
What is epigenetics?
heritable changes in marks on the DNA that do not change the nucleotide sequence but influence how genes are expressed (where, when and how much a gene is switched on or off)
What is believed to be the underlying mechanism of Barker hypothesis?
PROGRAMMING in utero leads to epigenetic changes which influence development and physiology
How does programming in utero influence development + health according to Barker hypothesis?
- foetal gene expression + maternal health and environment + foetal nutrient demands being more than supply
- leads to foetal development being altered (endocrinology, metabolism, foetal bone mass, fat mass, blood flow, vascular loading, altered immune response)
- this amplifies in infancy and adding adult exposures can lead to metabolic syndromes
What are metabolic syndromes?
obesity, diabetes, insulin insensitivity, hypertension, and hyperlipidemia and complications that include coronary heart disease, etc.
What diseases + illnesses further in life have been attributed to early environmental exposure?
• Cardio-vascular disease • Type 2 diabetes • Lung disease • Cancer risk • Neurological, special sense and intellectual development • Allergic and auto-immune diseases
How does the NHS try + mitigate DOHaD?
NHS Healthy Child programme
What is the NHS Healthy Child programme? What does it involve?
• Aims to prevent disease and promote good health universal + reduce health inequalities
• Health Promotion (Obesity prevention is a key aspect)
• Supporting care giving and care givers
• Screening
• Immunisation
• Identification of high-risk families/
individuals for additional support
• Signposting accident prevention + dental hygiene
What are the fundamentals of a screening test?
- Disease it is screening for should be able to identified early/before critical point, treatable, and aim to prevent/reduce morbidity/mortality
- Acceptable/easy to administer
- Cost effective
- Reproducible and accurate results
What are examples of Important Early Childhood Screening?
- Newborn Check
- Newborn Hearing Screen
- Blood spot check
What are some pre-conception screening tests?
• diabetic eye test screening for women pregnant with T1DM or T2DM
