Realizing the Potential of Adolescence to Prevent Transgenerational Conditioning of Noncommunicable Disease Risk: Multi-Sectoral Design Frameworks

Abstract

Evidence from the field of Developmental Origins of Health and Disease (DOHaD) demonstrates that early life environmental exposures impact later-life risk of non-communicable diseases (NCDs). This has revealed the transgenerational nature of NCD risk, thus demonstrating that interventions to improve environmental exposures during early life offer important potential for primary prevention of DOHaD-related NCDs. Based on this evidence, the prospect of multi-sectoral approaches to enable primary NCD risk reduction has been highlighted in major international reports. It is agreed that pregnancy, lactation and early childhood offer significant intervention opportunities. However, the importance of interventions that establish positive behaviors impacting nutritional and non-nutritional environmental exposures in the pre-conceptual period in both males and females, thus capturing the full potential of DOHaD, must not be overlooked. Adolescence, a period where life-long health-related behaviors are established, is therefore an important life-stage for DOHaD-informed intervention. DOHaD evidence underpinning this potential is well documented. However, there is a gap in the literature with respect to combined application of theoretical evidence from science, education and public health to inform intervention design. This paper addresses this gap, presenting a review of evidence informing theoretical frameworks for adolescent DOHaD interventions that is accessible collectively to all relevant sectors.

Knowledge about the Developmental Origins of Health and Disease is independently associated with variation in diet quality during pregnancy

“…Fortunately, the available literature also suggests that these kinds of barriers can be overcome. DOHaD-related concepts have been successfully translated to several hard-to-reach, albeit selected, populations with low levels of health literacy (adolescents in New Zealand and the Cook Islands, adolescents in Uganda, and low SEP women in the United Kingdom; Baird et al, 2014;Bay et al, 2012, 2016a, Bay, Morton, & Vickers, 2016b, Bay, Vickers, Mora, SLoboda, & Morton, 2017a, Bay et al, 2017bMacNab & Mukisa, 2017;Barker et al, 2017). In these selected cohorts, knowledge translation has required development of hands-on curricula and/or deep engagement and cultivation of meaningful relationships with community partners but is proving fruitful (Grace & Bay, 2011;MacNab & Mukisa, 2017).…”

Dietary and nondietary determinants of nutritional status among adolescent girls and adult women in India

“…Adolescence and young adulthood, represented by the childbearing age range, particularly in women, are critical time periods wherein optimal health and nutritional status can be achieved. 1 Nutritional insults during early childhood and maternal malnutrition, including micronutrient deficiencies, 2,3 have devastating effects and often traverse into adolescence and later life with long-term effects on health, cognition, education, and productivity. [4][5][6] Adolescence is now identified as the second window of opportunity, after the first thousand days of life, to improve nutritional inadequacies and inadequate growth and development from childhood.…”

Fish oil supplementation during adolescence attenuates metabolic programming of perinatal maternal high-fat diet in adult offspring

“…beneficial and safe for this critical window of development. Furthermore, obese children and adolescents are frequently inserted into obesogenic environments with poor familiar habits that could have programmed their metabolism since perinatal life (15,16) . Therefore, it is necessary to investigate potential interventions to prevent or improve metabolic outcomes induced by perinatal maternal dietary choices.…”