Context

The conditions around conception and within the womb have a lasting effect on a child¡¯s life. Known as the Developmental Origins of Health and Disease (DOHaD) concept, our researchers in BOBÌåÓýµÇ¼ÍøÖ·_Å·±¦ÌåÓý¹ÙÍøƽ̨-APP|ÏÂÔØ showed in the early 1990s, that exposure to certain environment influences at critical periods of development and growth will have significant consequences for the individual¡¯s short and longer-term health. This generated much international interest, and a search for the underlying mechanisms and possible routes to new interventions to prevent chronic diseases, starting before conception and during the first 1000 days of life.

Research challenge

Research at BOBÌåÓýµÇ¼ÍøÖ·_Å·±¦ÌåÓý¹ÙÍøƽ̨-APP|ÏÂÔØ since 2000 has seen the DOHaD field take significant strides forward and its impact has been felt on clinical practice and health policy around the world.

BOBÌåÓýµÇ¼ÍøÖ·_Å·±¦ÌåÓý¹ÙÍøƽ̨-APP|ÏÂÔØ studies caused a major revision of the concept that non-communicable diseases (NCDs) are predominantly a combination of inherited fixed genetic risk and unhealthy adult lifestyle, with the realisation that these factors do not account for the substantial number of people in a population developing NCDs

The studies demonstrated the importance of early life epigenetic changes ¨C related to aspects of the diet, lifestyle or adiposity of mothers and fathers ¨C in relation to a range of childhood risk factors for later NCDs in the next generation.

The DOHaD Centre has conducted qualitative research to explore how these new concepts can inform health policy, particularly in the prevention of childhood obesity and cardiovascular disease risk and the application of life-course concepts underlying DOHaD.

Impact on intergovernmental, government and NGO health policy

The research has led to recommendations by WHO in relation to the prevention of childhood obesity, through the Commission on Ending Childhood Obesity , and the Nurturing Care Framework . These have been adopted by the World Health Assembly and are now having an effect on government nutritional policy in many countries.

The research also influenced policy development and debates in the UK, with Professors Mark Hanson and Keith Godfrey co-authoring a chapter on preconception health for the Chief Medical Officer¡¯s 2014 Annual Report , and making a significant contribution to parliament POSTnote The Ageing Process and Health .

In 2019, Professor Hanson and Professor Godfrey established the first ¡®Preconception Partnership¡¯, comprising leading epidemiologists, scientists and clinical academics. Their proposal of an annual report card to measure progress in improving a set of preconception health markers was taken up by Public Health England.

E-learning platforms for early life nutrition and management of malnutrition

Professor Godfrey and colleagues initiated e-learning platforms to educate the healthcare workforce, in both low-middle and high income settings, on early life nutrition. The platforms have been distributed to healthcare professionals and young couples in areas such as Africa, Europe, the Middle East and South East Asia.

From 2015 to 2017, an e-Learning programme for management of malnutrition cut mortality rates from severe acute malnutrition from 5.8% to 1.9% in Ghana, Guatemala and El Salvador. The course has been taken by 17,000 health professionals, trainees and educators in 120 countries.

Increasing health literacy and inspiring positive lifestyle changes among teenagers

Alongside colleagues at BOBÌåÓýµÇ¼ÍøÖ·_Å·±¦ÌåÓý¹ÙÍøƽ̨-APP|ÏÂÔØ Education School, Professors Hanson and Godfrey developed a purpose-built teaching laboratory, LifeLab , at BOBÌåÓýµÇ¼ÍøÖ·_Å·±¦ÌåÓý¹ÙÍøƽ̨-APP|ÏÂÔØ General Hospital to engage school students about how their current health and life choices affect the health of their future children.

LifeLab is a structured education programme over a two-week period and includes a professional development day for science teachers and an immersive, hands-on visit to the LifeLab facility.

Since the facility was formally launched in 2014, more than 11,500 school pupils from 66 schools have participated in the programme.

Through a randomised controlled trial, LifeLab showed improvement in participating students¡¯ understanding of the influences of health behaviours on their long-term health and that of their children and encouraged them to judge their own lifestyles more critically.