Developmental origins of non-communicable disease: implications for research and public health

Abstract

This White Paper highlights the developmental period as a plastic phase, which allows the organism to adapt to changes in the environment to maintain or improve reproductive capability in part through sustained health. Plasticity is more prominent prenatally and during early postnatal life, i.e., during the time of cell differentiation and specific tissue formation. These developmental periods are highly sensitive to environmental factors, such as nutrients, environmental chemicals, drugs, infections and other stressors. Nutrient and toxicant effects share many of the same characteristics and reflect two sides of the same coin. In both cases, alterations in physiological functions can be induced and may lead to the development of non-communicable conditions. Many of the major diseases - and dysfunctions - that have increased substantially in prevalence over the last 40 years seem to be related in part to developmental factors associated with either nutritional imbalance or exposures to environmental chemicals. The Developmental Origins of Health and Disease (DOHaD) concept provides significant insight into new strategies for research and disease prevention and is sufficiently robust and repeatable across species, including humans, to require a policy and public health response. This White Paper therefore concludes that, as early development (in utero and during the first years of postnatal life) is particularly sensitive to developmental disruption by nutritional factors or environmental chemical exposures, with potentially adverse consequences for health later in life, both research and disease prevention strategies should focus more on these vulnerable life stages.

Figure 1

Periods of vulnerability to environmental influences. The most critical period is the perinatal period, during which epigenetic plasticity is high and can be influenced by a variety of environmental cues, including chemicals, nutrition, infection, etc.). Later in life, growth and the hormonally active puberty period is also a vulnerability period. In adults it is believed that elder persons are more vulnerable to a variety of insults

Figure 2

Common mechanisms of nutritional disturbance and environmental chemicals. Both nutritional unbalance and exposure to environmental chemicals can alter hormonal regulation, metabolic pathways, cellular plasticity and a variety of stress signals such oxidative and endoplasmic reticulum stress. These influence epigenetic factors such as DNA methylation, histone post translational regulation and noncoding RNA expression. However, these epigenetic effects in turn alter cellular and physiological pathways which may exacerbate their effects, ultimately leading to long term effects and children or adult diseases