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Preventing the transmission of non-communicable disease risk between generations

Published: 31 July 2022

Epigenetics is the study of how behaviour and environment affect the way our bodies read DNA sequences, and therefore how our genes work. Our researchers have shown that epigenetic processes influence the transmission of disease risk across generations, and that this can be mitigated by changes in diet and lifestyle. This knowledge has helped to inform health policies both in the UK and internationally.

History

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, Southampton researchers showed in the early 1990s that certain environmental factors during development have significant consequences for the individual's health.

This understanding sparked an international 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

Since 2000, our research into DOHaD has positively impacted clinical practice and health policy around the world.

Our studies have influenced major revisions to the idea that non-communicable diseases (NCDs) are mainly a combination of inherited fixed genetic risk and unhealthy adult lifestyle. In truth, these factors do not account for the substantial number of people developing NCDs.

Instead, the studies demonstrated the importance of early life epigenetic changes, related to the diet and lifestyle of both mothers and fathers, in determining a range of childhood risk factors for NCDs.

Researchers in Southampton's DOHaD centre have also carried out qualitative research to explore how this new understanding can inform health policy, in particular for the prevention of childhood obesity and cardiovascular disease.

Our work has established that people who were small at birth and had poor growth in infancy have an increased risk of adult coronary heart disease and type 2 diabetes, particularly if this is followed by increased childhood weight gain.
Associate Dean Enterprise

Public health policy

As a result of this qualitative research, the World Health Organisation (WHO) has updated its recommendations through the Commission on Ending Childhood Obesity and the Nurturing Care Framework. These have been adopted by the World Health Assembly and are now affecting government nutritional policy in many countries.

The research also influenced policy 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. They also contributed to a parliament POSTnote: The Ageing Process and Health.

In 2019, Mark and Keith established the first 'Preconception Partnership', proposing an annual report card to measure the progress in improving various preconception health markers. The report has since been adopted by Public Health England.

Education

E-learning platforms

Professor Godfrey and colleagues created early life nutrition e-learning platforms to educate the healthcare workforce in both low-middle and high income settings. They have distributed these platforms to healthcare professionals and young couples around the world, including:

  • Africa
  • Europe
  • the Middle East
  • South East Asia

From 2015-2017, an e-learning programme for the management of malnutrition cut severe acute malnutrition mortality rates, 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.

LifeLab

Mark and Keith worked with colleagues at Southampton Education School to develop LifeLab - a structured education facility designed to teach school students about how their current health and life choices can affect the health of their future children.

Since the facility was formally launched in 2014, more than 11,500 pupils from 66 schools have participated. A randomised controlled trial showed improvement in participating students' understanding of how their health behaviours influence both their health and those of their future children.

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