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Early Origins of Health Theme

Led by A/Professor Rebecca Robker and A/Professor Michael Stark

Early Origins of Health Theme

The health of every child is profoundly influenced by events in early life. Early life environment determines the trajectory of future metabolic and cardiovascular health, immune and reproductive health, and neurological function. Parental health and well-being prior to conception, during pregnancy and in early postnatal life determines the quality of this crucial early environment.

We seek to understand the mechanisms underlying these links. This is essential to develop effective interventions, to identify early prognostic markers of risk and to define optimal parental health and lifestyle. This knowledge and tools are needed to inform pregnancy care guidelines and public health policy and their application, including stratification of individuals and groups for targeted interventions.

Common factors that affect the gametes, embryo, fetus, infant or child, to alter offspring health, include:

  • Poor nutrition, lack of or excess physical activity, infection, stress, shiftwork,
  • Obesity, diabetes, hypertensive disorders, asthma and
  • Prematurity and intrauterine growth restriction.

These links in part reflect shared genetics and postnatal familial environments, but an additional pathway is now recognised, that of developmental programming. This phenomenon is not confined to maternal influences - the health of the father can also program the health of the next generation.

We also understand that many adverse parental factors are strongly associated with disadvantage, including for Indigenous people; their socio-cultural context must therefore be understood, to develop and adapt interventions and policy to be effective for the most affected.

We are well-placed to tackle this research challenge - we have conducted some of the largest trials in the world investigating interventions in pregnant women or in newborn infants to improve outcomes for the mother and/or child. In addition we collaborate with other leading global research centres and networks in this field - such as the MRC Integrative Epidemiology Unit at the University of Bristol and the EU Early Nutrition Research Framework (a consortium of over 30 leading universities and organizations).

Our major findings in this area include:

  • Showing that dietary and lifestyle intervention in pregnant women who are overweight or obese, improves diet quality and increases physical activity, reducing the number of babies weighing more than 4kg at birth
  • Demonstration that metformin compared to insulin treatment of women with gestational diabetes may increase subcutaneous adiposity in children
  • Identifying in late preterm babies an increased risk of impaired neurological function in childhood
  • Showing that food insecurity and number of house moves predict child obesity, independent of other factors, highlighting pathways or mediators whereby social disadvantage contributes to health outcomes
  • Defining how insulin action impaired by IUGR impairs metabolic health in offspring showing that neonatal treatment to promote insulin secretory capacity can improve some outcomes;
  • Demonstrating that paternal obesity and poor diet programs obesity and impaired metabolic health in the next two generations of offspring in a non-human species model, and identifying some of the paternal signals to offspring that may be involved

The next steps are:

  • Follow-up of the infants and children of overweight and obese mothers, to determine if this improves child cardiometabolic, allergic and cognitive health
  • Exploration of the impact of paternal obesity on the cardiometabolic health of children
  • Identifying biomarkers and risk stratification tools that predict an overweight or obese mother's risk of poor pregnancy health or of her child having poor health
  • Testing of interventions (exercise and improved diet quality) in the obese father in experimental non-human model species to improve metabolic health of offspring
  • Follow-up of the children of mothers with asthma to examine their cardiovascular profile, neurodevelopment and allergic susceptibility
  • Testing of interventions (exercise and improved diet quality) in the obese father in experimental non-human model species to improve metabolic health of offspring
  • Testing of interventions (micronutrients, exercise and modifiers of insulin action), in the mother with experimental placental restriction or her IUGR offspring to improve their metabolic health
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