Developmental epigenetics and risks of later non-communicable disease

Abstract

Non-communicable diseases (NCDs) are becoming more prevalent globally than communicable diseases and until recently there was little international attention to the need to address them. The rising incidence of NCDs is of particular concern in low and middle income countries as they benefit from socio-economic improvement that is exacerbated by demographic changes, including changes in population age structure. Initiatives to curb the rise in NCDs have often focused on overweight and obesity, which increase risk substantially. However, the focus has largely been on individual responsibility for lifestyle choices and this approach has been met with limited success. However, predisposition to such conditions is partly set in early development, when parental diet, lifestyle and other factors influence offspring’s metabolism, appetite and other physiological control systems. We are now discovering how epigenetic processes that mediate developmental plasticity influence offspring phenotype without affecting genotype. This awareness will allow the early identification of individuals at greater risk of NCDs later and will encourage the introduction and monitoring of preventative interventions. We present a life-course perspective on NCD risk, stressing transgenerational transmission of NCD risk and arguing that effective interventions should focus on adolescent/young adult lifestyle and health literacy for the challenge of NCDs in the next generation to be met effectively.