Early-life risk factors for chronic nonrespiratory diseases

Abstract

We have witnessed a change in disease patterns contributing to the global burden of disease, with a shift from early childhood deaths due to the classic infectious communicable diseases to years lived with disability from chronic noncommunicable diseases. In both developing and developed countries, the years lived with disability attributable to chronic disease have increased: cardiovascular diseases by 17.7%; chronic respiratory disease by 8.5%; neurological conditions by 12.2%; diabetes by 30.0%; and mental and behavioural disorders by 5.0% over the past 20 years. Recognition of the contribution made by adverse environmental exposures in early life to noncommunicable diseases in later life is increasing. These earlylife exposures appear to contribute to both chronic respiratory and chronic nonrespiratory diseases. In this State of the Art article, we aim to examine early-life environmental exposures that have an epidemiological association with chronic nonrespiratory diseases, such as obesity and type II diabetes, cardiovascular disease, and neurocognitive and behavioural problems. We will highlight the potential overlap in environmental risks with respiratory diseases, and point out knowledge gaps and research opportunities. @ERSpublications Respiratory diseases are linked to obesity/diabetes/metabolic syndrome, CVD and neurocognitive/behavioural disorders

Health Consequences of Environmental Exposures: Causal Thinking in Global Environmental Epidemiology

“…On face value, it is easy to understand why exposure to particulate matter in ambient air would increase the risk for respiratory disease, but why would the same exposure induce insulin resistance, obesity, and type 2 diabetes? 28 Among the mechanisms postulated to link respiratory and metabolic diseases are common exposures during fetal development (maternal smoking, maternal stress) and in early life (diet low in antioxidants and fresh fruit and vegetables, ambient air pollution) (reviewed in Chacko et al 29 ). In addition, both respiratory and metabolic diseases are "inflammatory" conditions and oxidative stress plays a role in both.…”

“…In addition, both respiratory and metabolic diseases are "inflammatory" conditions and oxidative stress plays a role in both. 28 Low lung function has been associated with obesity and type 2 diabetes and asthma symptoms are seen in those with the metabolic syndrome (reviewed in Chacko et al 29 ). Although extreme obesity may impose mechanical limitations on the chest wall, reducing lung function, this is an uncommon situation and not likely to explain the links between metabolic and respiratory diseases.…”

Health Consequences of Environmental Exposures in Early Life: Coping with a Changing World in the Post-MDG Era

“…27 Although cesarean deliveries and antibiotic use are not considered environmental exposures, both can result in changes in the gastrointestinal microbiota, known as dysbiosis, which increases the risk for chronic disease. 28 The infant bowel is sterile at birth and acquires its microbiota by passage through the birth canal, from early feeding patterns, and from the environment. Establishment of the normal gut microbiota can be disrupted by cesarean delivery, premature birth, or increasing use of antibiotics during pregnancy.…”

“…Establishment of the normal gut microbiota can be disrupted by cesarean delivery, premature birth, or increasing use of antibiotics during pregnancy. [28][29][30] Infants born by cesarean delivery have lower diversity in gut microbiota and a reduction in normal immune responses. 29 Evidence is increasing that the population of gut microbes in each individual are an integral part of the individual's genetic profile and influence risk for disease by playing a key role in stimulation and maturation of the immune system, as well in the biotransformation of environmental xenobiotics.…”

Stress und optimales Altern

“…Die Entwicklungen in der biologischen Grundlagenforschung [64,65] machen es zunehmend möglich, diese Ergebnisse in einen klinischen Bezug [66][67][68][69][70] und einen kontextualen, den Lebenslauf integrierenden Rahmen [71,72] zu setzen und mit Fokus auf das Individuum einerseits und die Gesellschaft andererseits geeignete Interventionen zu entwickeln.…”