The big picture Flashcards
What is the overall trend of obesity prevalence by deprivation decline?
There is a positive correlation seen between the data of those most deprived and least deprived
National child measurement programme change in gap
Can the epidemic of childhood obesity be tackled by just placing substantial taxes on high sugar products?
Research indicates that a 20% price increase for confectionary (including chocolate), biscuits and cakes would result in falls in obesity around what value…
A. 15%
B. 10%
C. 5%
D. 2.5%
D. 2.5%
Why are we losing the war against obesity?
Because we intervene too late
For coronary heart disease
What is the trend in the standardised mortality ratios (SMR) between men and women?
Lower birth weight individuals have higher death rate from heart disease
Tell me the relationship that has been observed between boys birth rate and their ability to cope in stressful situations
Boys of high birth weight cope well during a stress challenge, but those of lower birth weight have high stress hormone levels and are more anxious
Resilience to environment is set during our early development. This is well established in animal biology. Link to birthweight
A poor start in life has lasting effects on multiple organs and control systems in the offspring. What areas does it affect?
- Fat, muscle, and bone
- Heart, lungs, and kidneys
- Metabolic and stress responses
- Mood and behaviour
- Ability to learn and cognitive function
- Timing of puberty, reproductive function
- Immune responses
The effects can be subtly, so they don’t immediately signal danger
But they have lifelong consequences, altering how a person responds to their later environment and lifestyle
Impaired early development increases the risk of what?
Obesity and sarcopenia
Osteoporotic bone fractures
Coronary heart disease and type 2 diabetes
Atopic and respiratory disorders including eczema and COPD
Mental ill-health and behavioural disorders
Hormonally related cancers
What have experimental studies indicated about effects on early development?
- Maternal undernutrition, obesity and stress and major drivers
Maternal and paternal effects
- Developmental effects act over several generations
Effects past through male gametes from grandfather if they had something
- Epigenetic changes in non-imprinting genes are a key mechanism
Developmental epigenetic plasticity
During early life, “developmental epigenetic plasticity” enables what?
Predictive adaptive responses, which evolved to tune the phenotype to the anticipated future environment
Individuals whose developmentally induced phenotype is “mismatched” to their subsequent environment are at an increased risk of what?
Adult cardiovascular disease, type 2 diabetes and obesity
Early nutrition and stress alter development. What does this act through in order to do this?
Act through epigenetic and other processes, and may underlie parental and transgenerational influences on NCD risk
How does epigenetics play a role in development?
The development and maintenance of plants and animals is orchestrated by reactions that twitch parts of their DNA on and off at strategic times and locations
Epigenetics is a study of these reactions and the factors that influence them
Plants and animals use epigenetic processes to adapt their development to the environmental experiences in early life
Example is shown below
How does epigenetics effect the Meadow vole (Microtus pennsylvanicus)
Maternal photoperiod before conception determines coat thickness in offspring
How does epigenetics plat a role in the human genome?
Epigenetics underlies differences between cells
Changes in gene function that do not depend on DNA sequence
Gene expression changed: methylation of CpG sites and chemical changes in the histone proteins alter “packaging” of DNA; non-coding RNAs have a variety of roles that alter gene transcription
CpG sites: The CpG sites or CG sites are regions of DNA where a cytosine nucleotide is followed by a guanine nucleotide in the linear sequence of bases along its 5’ → 3’ direction
Effect of genotype and in utero environment on neonatal methylomes (237 singapore infants)
Prenatal environment plays a dominant role in birthweight (and later adiposy) Vs. genetic influences (polygenic risk score, PRS)
How does a higher birthweight affect the odds for an individual having type 2 diabetes?
Men and women born after a famine period contribute an excess of diabetic patients…
Not just gestational diabetes, but even normal higher fasting glucose levels increases what?
Birthweight and adiposity
Explain and give examples for the developmental overnutrition hypothesis
Give some examples for different exposures from Preconception, pregnancy, infants and toddlers that act through specific mechanisms (state these) that can lead to different child obesity and adiposity risk (such as abnormal growth and fat deposition, insulin resistance and disease risk)
Greater number of maternal/ early infancy adiposity risk factors- substantially increased risk of child overweight and obesity
Epigenetic “marks” in perinatal tissue: strong associations with childhood fat mass and % fta in 2 independent cohorts
Low maternal carbohydrate intake in early pregnancy is associated with what?
Higher umbilical cord RXRA gene promotor methylation in the Princess Anne hospital study
Perinatal RXRA methylation, maternal 25(OH)D and offspring bone mass: observation to intervention
What processes the phenotype from the genome are affected by
Foresight “tackling obesities: future choices”
- Considered 17 different potential government policy responses across built, health, fiscal, research, educational, regulatory, social structure, and family domains
- The only one with a significant impact on obesity in all three scenario contexts explored was…
- “… to promote/ implement a programme of early interventions at birth or in infancy”
- Since 2007, new evidence suggest that inventions before/during pregnancy may have even greater impact, but foresight still concluded”
- “Intervention in early life generated the highest average impact across all scenarios”
- “Greatest success was achieved in scenarios where a long-term approach prevailed, and where society was prepared to measure success over longer timeframes”
Increased adjusted all cause premature mortality in adult offspring of obese mothers (BMI >30)
What results did the UPBEAT: UK better eating and activity trial come out with?
What factors are affected with the following:
- Preconception
- Paternal obesity and undernutrition
- Maternal obesity and Overnutrition
- Maternal undernutrition
- Assissted reproductive treatment (ART)
Little evidence that women improve lifestyle pre-pregnancy
6 months after Life lab, students have persisting changes in beliefs about food and health, and have increased preferences for studying science and following healthcare careers
Life lab Southampton- science and health literacy
Dedicated teaching programme at the heart of a major teaching hospital enables 4000 students per year to:
- Experience for themselves exciting developments in science: focus on understanding how our early lives have effects on our later health
- Learn how they can improve their own health and the health of their future children under a framework of ‘Me, my health and my children health’
- Become enthusiastic about science such that they consider further study and careers in science disciplines
Why focus on adolescents?
- Known to have poor diet
- Adopters of eating innovations
- Foundations of adulthood are consolidated
- Critical period of development
- Begin to make independent choices
- Purchasing power + social opportunities
- Parents and leaders of tomorrow
- Strong interest in planetary health
Multiple dividends if invest in adolescents:
- Them now
- Them in the future
- Their current families and peer
- Their future families
- Wider society
- The environment
