Early environmental and biological impacts on lifelong health

Question 1

What challenges could the fetus face in utero that might have lasting impact on its health?

Answer 1

• Infection
• Maternal nutrition
• Maternal illness
• Maternal medication
• Environmental factors

Question 2

what are the Nature and Nurture factors that can contribute to long term health and risk of disease?

Answer 2

NATURE

• Genetics
• Epigenetics
• Perinatal Influences

NURTURE

• Environment
• Family, Neighbourhood, School
• Nutrition
• Social - behaviours seen – substance use, care giver behaviour
• Health Provisions

Question 3

Summarise the barker hypothesis

Answer 3

• Adults who had coronary events had been small and thin at birth then rapidly put on weight.
• They didnt follow the trajectory of growth expected.
• Hence tempo is important

Hence undernutrition in utero and overnutrition in childhood can lead to increased risk of metabolic syndrome.

They have the thrifty phenotype - more likely to gain weight

Also called “Developmental origins of adult disease hypothesis”

Question 4

Summarise the early life origins concept, i.e. what can (detrimental ) early environmental exposures lead to?

DRAW THE PATHWAY

Answer 4

Early environmental exposures can lead to :

• CVD
• Type2 diabetes
• Lung cancer
• Cancer risk
• NeurologicaL;, special sense and intellectual development
• Allergic and auto-immune diseases

Question 5

what tool can can you use to help see how the older generational factors can affect your health

Answer 5

Draw a genogram

Question 6

Summarise the aims of the NHS Healthy Child Programme

Answer 6

Aims to prevent disease and promote good health

• universal
• reduce health inequalities

Question 7

Summarise the actions of the NHS Healthy Child Programme

Answer 7

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

Question 8

what are the fundamentals of a good screening test

Answer 8

The Disease it is screening for

• should be able to identified early/before critical point
• treatable
• prevent/reduce morbidity/mortality

Test should be:

• Acceptable/easy to administer
• Cost effective
• Reproducible and accurate results

Question 9

Summarise the Sure Start program

Answer 9

High level of investment in children’s community centres

Help support families with under 5 year old children in low income households

Education

Health promotion

Question 10

Summarise all the screening programmes during and after pregnancy

Answer 10

Question 11

what is the thrifty phenotype?

Answer 11

it has to do with Barker hypothesis

‘Thrifty phenotype’
• Idea is that the baby who was not well nourished in utero (typically because of reduced placental blood flow that they’re not growing very well)
• Then, they are likely to (through epigenetic changes) become more thrifty/ acquisitive of calories
• Hence, they want to store energy in fat stores, because they are not growing as well as they genetically intended to
• Those epigenetic changes lead to long-term metabolic changes so that outside of the womb they continue to deposit fat & energy stores more easily than other people
• Therefore, they are at high risk of become obese & developing metabolic syndromes
• This is the theory
• Whereas, a child in the womb of a well-nourished mother, with a good placental blood supply, and growing well, don’t develop these epigenetic changes related to thrifty phenotypes - they don’t have this increased coronary heart disease