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15 - Patterns of growth: relevance to developmental origins of health and disease

Published online by Cambridge University Press:  08 August 2009

By
Johan G. Eriksson
Edited by
Peter Gluckman  and
Mark Hanson
Johan G. Eriksson
Affiliation:
National Public Health Institute, Finland
Peter Gluckman
Affiliation:
University of Auckland
Mark Hanson
Affiliation:
University of Southampton
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Summary

Introduction

Epidemiological studies have contributed enormously to our understanding of the natural history of many non-communicable diseases like coronary heart disease (CHD) and type 2 diabetes. Although clinical manifestations of these conditions normally become evident in adult life, early signs are recognisable already in children (Holman et al. 1958, Strong and McGill 1962, Berenson et al. 1979). A greater understanding of the evolution of many chronic diseases and their risk factors early in life is important for their primary prevention as well as in order to get a better understanding of the disease pathogenesis. The discovery that people who develop CHD and many of its risk factors in adult life grow differently during early life has led to the recognition of new developmental models for the disease and its risk factors. In this chapter, patterns of growth will be focused upon primarily in relation to CHD and type 2 diabetes as disease outcomes.

Prenatal growth

David Barker proposed that the epidemic of CHD in Western countries might have its origin in fetal life. He observed that areas in the UK with the highest rates of neonatal mortality in the 1910s and 1920s had the highest rates of CHD in the 1970s and 1980s. Based on these observations he postulated that impaired fetal growth predisposes to heart disease in adult life; studies in Hertfordshire, UK, proved the hypothesis to be correct (Osmond et al. 1993).

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Developmental Origins of Health and Disease , pp. 223 - 232
Publisher: Cambridge University Press
Print publication year: 2006

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