Impact of the environment on lifelong health Flashcards
What challenges could the fetus face in utero that might have lasting impact on its health?
- Fetal infection in utero
- Maternal nutrition
- Evidence to suggest:
- High fat or low protein diets can have impacts
- Low protein → neuronal development
- Maternal illness
- Maternal stress
- Maternal medication
- These can cross the placenta
- Environmental factors/exposures
What are the influences?
- Biological
- Genetics
- Epigenetics - Social and environmental cues
- Environment
- Family, Neighbourhood, School
- Nutrition (maternal and fetal/child)
- Social - behaviours seen – substance use, caregiver behaviour
(see Still Face Experiment on Insendi) - Health provisions
What occurs in the still face experiment?
- Work to co-ordinate mother and baby’s feelings
- Then mother stops responding → baby tries to reconnect
- Screaming, they reach out
- Then baby turns away, loses posture and starts crying
What is the Barker hypothesis?
Early life influences can be predictors or influences of health status in adulthood
What did the Barker hypothesis focus on initially?
Birth weight and growth and its link CVD and other coronary events
What did the Barker hypothesis find?
The rate of growth of children could be correlated with the frequency of current events that they experienced in adulthood as adults.
What did the Barker hypothesis conclude?
The risk of coronary events in these individuals was more strongly related to the rate of change in childhood BMI, rather than to the BMI that the child detained at any particular age of childhood.
What is the mechanism?
Gene-environment interaction leads to epigenetic changes which influence development & physiology
What are 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)
Which diseases can you link?
- Cardio-vascular disease
- Type 2 diabetes
- Lung disease
- Cancer risk
- Neurological, special sense and intellectual development
- Allergic and auto-immune diseases
What is the aim of the NHS healthy child programme?
Aims to prevent disease and promote good health
- Universal
- Reduce health inequalities
What does the NHS healthy child programme provide?
- 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 makes a good screening test?
The Disease it is screening for should
- be able to identified early/before critical point
- treatable
- prevent/reduce morbidity/mortality
- Acceptable/easy to administer
- Cost effective
- Reproducible and accurate results
What are examples of screening tests?
- Newborn Check
- Newborn Hearing Screen
- Blood spot check
What is sure start?
Government scheme where there were high level of investment in children’s community centres
