A Life Course Approach to Chronic Disease Epidemiology
Recent epidemiological research has forced us to question our current beliefs that the causes of coronary heart disease and cancer arise in adulthood. A new school of thought has emerged which argues that the chronic diseases prevalent in adult life have their origins during gestation, infancy, and childhood. A large body of evidence for this hypothesis has built up from research findings scattered throughout the scientific journals. In A Life Course Approach to Adult Disease, researchers actively involved in this area critically review and examine the evidence for this hypothesis. In particular, the impact of factors acting in early life, and those acting later in the life course is assessed for cardiovascular, respiratory, and allergic diseases, as well as diabetes, hypertension, and breast cancer. The extent to which early life factors explain variations in disease risk for both individuals and populations is discussed. The book begins by presenting the historical development of ideas concerning chronic disease aetiology, and examines direct evidence for the role of in-utero programming and other pre-adult factors in the aetiology of many common diseases. The second section discusses the importance of socio-cultural influences on biological risk as well as the determinants of fetal growth and development. The book then goes on to look at the temporal, geographical, and social variations in disease frequency. The final section examines the role of interventions to alter fetal development and child growth, and the implications for future health policy. Throughout the book, the authors argue that the adoption of a life-course approach to the study of disease could greatly improve our understanding of the aetiology of chronic diseases, present possibilities for prevention, and have profound implications for health policy decision making.
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an historical perspective
Preadult influences on cardiovascular disease and cancer
Diabetes and insulin action
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adolescence adult chronic disease adult disease adult health adulthood aetiology allergic association asthma atherosclerosis Barker DJP behaviour biological birth cohort blood pressure body mass index breast cancer cardiovascular disease CHD mortality cholesterol clinical cohort studies coronary heart disease correlated Davey Smith death decline diet dietary differences differentials disease risk early life factors effects England and Wales environment Epidemiol Community Health Epidemiology evidence exposure fetal growth fetal growth retardation genetic gestational glucose intolerance groups growth retardation heart disease mortality Hertfordshire hypertension hypothesis impaired increase infant mortality influences insulin resistance intake intervention intrauterine ischaemic heart disease Lancet later levels London long term low birthweight measures middle age mortality rates myocardial infarction obesity Osmond patterns placental ponderal index population pre-eclampsia pregnancy prenatal prevalence programming Public Health ratio relationship Smith G smoking social class stroke suggested systolic thinness at birth trends utero variations Wadsworth MEJ women