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37 - Past obstacles and future promise

Published online by Cambridge University Press:  08 August 2009

By
D. J. P. Barker
Edited by
Peter Gluckman  and
Mark Hanson
D. J. P. Barker
Affiliation:
University of Southampton
Peter Gluckman
Affiliation:
University of Auckland
Mark Hanson
Affiliation:
University of Southampton
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Summary

Introduction

The idea that common chronic diseases are initiated through developmental processes that begin before birth arose from geographical studies published 20 years ago (Barker and Osmond 1986). The evidence was circumstantial and the mechanisms unknown. Today even a perfunctory reading of this book would lead to the conclusion that the ‘developmental origins of health and disease’ now has a sound scientific basis in both human and animal studies. This being so, the need to expand research is urgent. Almost a million people in the USA died of coronary heart disease last year. One hundred and fifty million people in the world have type 2 diabetes and the epidemic is rising. Ten million Americans over the age of 50 have osteoporosis and one out of every two women over the age of 50 will have an osteoporotic fracture in their lifetime.

Differences in adult lifestyle provide only a partial explanation of why one person develops these disorders while another does not; nor does lifestyle account for the higher rates of these disorders among poorer people and ethnic minorities in Western countries. The effects of modifying adult lifestyle, when formally tested in randomised trials, have been disappointingly small (Ebrahim and Davey Smith 1997). One explanation could be that there are differences in people's vulnerability to adverse lifestyles and hence differences in the benefits of lifestyle modification.

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Developmental Origins of Health and Disease , pp. 481 - 495
Publisher: Cambridge University Press
Print publication year: 2006

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