Developmental origins of health and disease: A lifecourse approach to the prevention of non-communicable diseases

Abstract

Non-communicable diseases (NCDs), such as cardiovascular disease and osteoporosis, affect individuals in all countries worldwide. Given the very high worldwide prevalence of NCDs across a range of human pathology, it is clear that traditional approaches targeting those at most risk in older adulthood will not efficiently ameliorate this growing burden. It will thus be essential to robustly identify determinants of NCDs across the entire lifecourse and, subsequently, appropriate interventions at every stage to reduce an individual’s risk of developing these conditions. A lifecourse approach has the potential to prevent NCDs, from before conception through fetal life, infancy, childhood, adolescence, adulthood and into older age. In this paper, we describe the origins of the lifecourse concept, the importance of early life influences, for example during pregnancy, examine potential underlying mechanisms in both cell biology and behavior change, and finally describe current efforts to develop interventions that take a lifecourse approach to NCD prevention. Two principal approaches to improving women’s nutritional status are outlined: nutritional supplementation and behavior change.