Developmental Origins of Health and Disease (DOHaD) Cohorts and Interventions: Status and Perspective

Abstract

The concept of Developmental Origins of Health and Disease (DOHaD), which has emerged over the past decades, links the state of health and disease in later life with environmental factors of the early life. It was the pioneer work of David J. Barker, Southampton University, United Kingdom, who proposed the fetal origins of adult disease hypothesis, also referred to as the ``thrifty phenotype{''} hypothesis or Barker hypothesis, which states that an adverse fetal environmental, such as undernutrition, increases the risk of noncommunicable diseases (NCDs) in adulthood. At the beginning of this century, the DOHaD theory incorporated much broader concepts: not only were poor physical conditions in adulthood, such as disease suffering, strongly associated with the fetal and infant environment, but also the ability to maintain a healthy lifestyle. Currently, the belief that adverse fetal-childhood environments, such as undernutrition, stress, smoking, and chemical exposure due to growth restriction, increases the risk of NCDs in adulthood, such as cardiovascular disease, stroke, hypertension, type 2 diabetes, chronic kidney disease, osteoporosis, cancer, and psychiatric disorders, is widely accepted. In Europe and America, birth cohort studies are very popular because they enable the integration of data sharing and meta-analyses for genome-wide association studies, epigenome-wide association studies, exposome, Mendelian randomization, and early intervention studies. Recently, in Japan, the concept of preemptive medicine, which is a novel medical paradigm that advocates for presymptomatic diagnosis, prediction, or intervention at an early stage to prevent or delay disease onset, has been proposed. Therefore, interdisciplinary studies that focus on fetal and childhood developmental periods are highly recommended as a political strategy. In this chapter, I will introduce DOHaD cohort studies and interventions and discuss their statuses and perspectives.