mom holding baby's hand

Developmental origins of health and disease

Originally hypothesized by David Barker, M.D., Ph.D., FRS, more than 30 years ago, the field of developmental origins of health and disease, also known as DOHaD, has grown exponentially since. Professor Barker based his work on observations that adult heart disease mortality in England was inversely correlated with low birth weight infants fifty years earlier. While initially met with skepticism, a surge of basic animal studies demonstrated the ways in which environmental adversities can compromise organ development and maturation of developing mammals. 

Epidemiologic data from multiple populations, time frames, and geographic areas as well as data from clinical and experimental studies followed, indicating that our earliest environments play a powerful role in predicting risk for many chronic diseases.

While the birth weight data have been replicated several times over in multiple countries, further research has led to the discovery of a number of additional pregnancy related factors that predict disease.

Dig deeper

Read a brief description of several issues impacted by developmental origins followed by a list of research articles to dig deeper into the science.

DOHaD overview
Birthweight and placenta
Developmental trade-offs
Toxic stress
Maternal phenotype
Breastfeeding and early nutrition
Food insecurity
Heart disease

Ten facts about chronic disease origins

  1. Babies who grew poorly during gestation and who are shorter or thinner than average are at higher risk for later chronic diseases. Such babies have compromised organs and enduring epigenetic modifications throughout life.
  2. It is now certain that the sensitivity to nutritional causes of disease is highest during a person’s early development.
  3. Maternal phenotype such as short stature, high body mass index, wide pelvis and small maternal head circumference have all been associated with chronic disease risk in adult life in offspring.
  4. While paternal body phenotype has not been studied, there are clear disease risks associated with malnutrition in fathers and grandfathers. These effects are promulgated via epigenetic modifications of sperm.
  5. The size and shape of the placenta is a powerful predictor of offspring disease risk.
  6. Disease risk is passed across many generations. The so-called 100 year effect is so named because chronic diseases risk in elderly adults can be traced, in part, back ~100 years earlier when the egg from which they were derived was nourished in the ovary of their fetal mother.
  7. Disease risk is additive across generations. This is the likely explanation for the rising rates of diabetes and obesity in the USA. Americans are in the 3rd generation of eating high calorie overly processed foods that contain few nutrients. Most American suffer from high calorie malnutrition.
  8. Toxic social stress during pregnancy inhibits the growth of the fetus and “programs” the baby for disease in later life.
  9. People carry disease risk according to the culture in which they found themselves during their developmental years. Thus social determinants of disease act through epigenetic mechanism to place populations at risk for poor health.
  10. Unlike inherited gene sequences, epigenetic mechanisms can be modified and detrimental pathways set in early can gradually be reversed. Thus, the current epidemic of chronic disease can be reversed if communities work together to improve the nutritional and stress environments in which we live.