Paediatrics: DOHAD Flashcards
What are the 4 most common non-communicable diseases?
Type 2 Diabetes mellitus
Heart disease
Chronic Obstructive Pulmonary Diseases (COPD)
Cancer
What are the big 4 risk factors for non-communicable diseases?
Poor nutrition
Smoking
Alcohol
Physical activity (lack of)
What percentage of deaths in underprivileged developing communities are caused by NCDs?
80%
What is the most common cause of anaphylaxis outside of the hospital?
Food allergy
Why is maternal obesity implicated in the development of NCDs in children they are pregnant with?
Obesity is a chronic inflammatory state.
Early immune dysregulation affects development of many organ systems.
How early is baseline CRP potentially programmed?
Before birth
Can metabolism be changed by microbiome?
Yes, affects immune system and brain development
What factors influence the microbiome?
How a baby is delivered
What we eat
Antibiotic use
What factors in health are influenced by microbiome?
In animals changing gut bacteria changes:
Weight gain, brain and immune system development, heart disease, diabetes risk, and longevity.
What are the beneficial effects of H. pylori? When are these results achieved?
Stimulates T reg tolerance
Appetite regulation (ghrelin)
When colonized early: Protects from GI pathology and other inflammatory diseases.
When colonized at maturity causes GI pathology and inflammatory diseases.
Timing is everything
What were the effects of eradicating H. pylori from a population?
Obesity and insulin resistance
IBD
Autoimmunity
Asthma and atopic disorders
What is the simplest and most effective way of changing ‘our’ genes?
By changing diet; this allows us to change our gut microbiome.
How early do food taste preferences get influenced?
Before birth
How many women drink during pregnancy?
15% excessive in first trimester
10% in 2nd trimester
These numbers are way higher in indigenous populations
What are the features of FASD?
Behaviour problems
Speech and language delay
Anxiety delay
ADHD
Learning difficulties
Autistic features
Thin upper lip
Smooth gutter between nose and mouth
Short eye openings
What is the most common condition related to alcohol exposure?
Lack of impulse control
What are the effects of being born too early?
Links with rising rates of NCDs
Neurological deficits
Obesity risk
CVD risk
Osteoporosis
Why is term birth so important?
During this period >1/3 of brain size is increased
5x increase in white matter volume >35 weeks
What effect does preschool screentime have on children?
For every hour of DVD watched a preschool child has 8 less words
> 2hr/d 6x risk of language disorder
Reduced working memory / hour screen time
What are the recommendations for kids that use electronic devices?
Avoid screen time under 2 years of age
Over 3 - 18 years limit entertainment screen time to 2 hours/day
Keep all electronics out of bedroom
Sit together at meal times
No snacks at computer or playing e games
Parents need to be good role models
What is used as a good early predictor of cerebral palsy? What else do they predict?
Absent fidgety movements, they also predict cognitive delay.
