Childhood antecedents of adult disease (when should prevention occur) Flashcards
What is lifecourse epidemiology
study of the long term effects on later health or disease risk, of physical or social exposures during gestation, childhood, adolescence, young adulthood and later adult life
How does under-nutrition during the gestational period increase the risk of cardio-metabolic disease in adulthood
fetal programming, perminantely shapes the body’s structure, function and metabolism.
way in which nutrients are metabolised is altered
explain the evidence linking low birth weight to increased risk of CHD
lower birth weight = greater risk of premature death from CHD (a gradient of risk)
<5.5lbs roughly 1.5 times more likely to die of CHD before 65 than those of 9.5lbs
explain the concept of the first 1000 days
a critical period from 9 months before birth until 2-3 years of age
lay down the foundations for health over this time period
non-optimal growth during this period can predispose many diseases, mainly cardiometabolic
explain the concept of developmental plasticity
upon exposure to a certain risk factor, certain genotypes may alter the phenotype which they express
explain how early growth leads to CHD problems
nutrient poor environment leads to child being metabolically programmed to metabolise food and sugars differently
set up as if they’re in a nutrient scarce environment or to catch up with growth
there is the possibility that this also decreases the ability to undertake PA, so this is also a negative effect
explain the concept of the adiposity rebound
in early years, children have a high BMI, but this excess energy is used up during growing so BMI begins to fall
adiposity and BMI then begins to rise again between the age of 3-7
what association has been found between low birth weight and the timing of the adiposity rebound
lower birth weight = earlier adiposity rebound
earlier adiposity rebound = higher BMI in later childhood and into adulthood
Give 3 reasons why it is hard to study the effects of early growth on later life
need a very large cohort to find anything
ethically couldn’t subject someone to a bad diet
observational studies are possible but don’t show causation
what were some of the shorter term impacts found from the hunger winter studies
not smaller if exposed to the starvation in the first or second trimester
300g smaller if exposed in the third
what were some of the longer term impacts of the hunger winter study
reduced glucose and lipid regulation
female offspring exposed in the first trimester had higher BMI
higher risk of diabetes
Explain the thirfty pheontype hypothesis
there is different methylation of the epigenome when the baby is developing in a nutrient poor environment
this sets the baby up for a more nutrient scarce environments after birth, because this is representative of the gestational environment and so therefore would give a survival advantage
Childhood environment generally isn’t nutrient scarce and so this instead increases their susceptibility to metabolic disease
Describe the general relationship between birth weight and risk of death from heart disease
high risk at very low birth rates
linear decline until around 10lbs
then increases again for high birth weights
How does early growth impact on the ability of a child to undertake PA
LBW or SGA have greater risk of poor motor control
have greater adult sedentary behaviour
increased sedentary behaviour
decreased variety of activities that they take part in
greater adiposity and different location of body fat
What impacts on physical fitness are seen in babies born <37 weeks
decreased lung capacity
(more lung disease e.g asthma)
decreased levels of PA
what impacts on physical fitness are seen in babies born <1500g
decreased strength
decreased endurance
decreased flexibility
define the term epigenetics
study of biological mechanisms which swithch genes on and off
why could knowledge of epigenetics potentially be useful
development of disease could be more malluable than thought
could identify ways to prevent and treat disease e.g nutrition or environmental exposure
what evidence is there that PA leads to health beneficial changes to genetics
23 men exercised 2 times per week
lead to ways in which fat was stored and changes in over 7000 genes
has also been evidence of change in genes relating to: metabolism muscle growth inflammation blood formation (in response to activity)
For which ethnic group is it recommended that the BMI cut points should be changed, and what is the reason for this
South Asian
they have a greater disease risk for the same BMI when compared to other ethnic groups
also likely to be LBW or SGA so have a greater risk of cardiometabolic disease
Why should exercise guidelines also be different depending on ethnicity
SA group needed to do more than 150min/week of exercise to get the same benefit in terms of beneficial changes in biological markers for disease than a white group
What benefits as a result of exercise, to mothers, have been published
stress relief better glucose control aiding post pregnancy weight loss reduces pre-eclampsia risk reduced rates of cesarean section
what benefits as a result of exercise have been published in relation to the offspring
better insulin markers reduced obesity (could just be bc in a more active family)
what are the possible negative effects of exercise during pregnancy
greater injury risk bc of greater ligament laxity
increased tiredness
less resistant to heat stress when pregnant
what are the recommendations for exercising whilst pregnant
no contact sport
60-90% max HR
15 mins, 3x per week which can progress to 30 mins 4x per week
what is the association between low birth weight, accelerated infant growth and lower aerobic fitness
those with lower birth weight and accelerated growth had lower aerobic fitness
this association was not mediated by levels of MVPA and therefore is a true association
what are some strong points of the reading for this week
growth data was collected prospectively
had objective measures of body composition
accounted for a large numbers of confounders
what are some of the limitations of the reading for this week
only dutch participants
FFM was assessed 3 years before physical fitness (lots of time for changes to occur)
