Developmental Origins of Health and Disease: Challenges and Payoffs

The novel paradigm of Developmental Origins of Health and Disease posits that the pre- and peri-natal periods are critical to development of chronic disease throughout life. Animal experiments have proven the principle many times over that environmental perturbation of the fetal supply line has long-lasting cardio-metabolic effects on the offspring. Quantifying the extent to which these processes operate in human populations has been challenging. Newer epidemiologic study designs, including sib-pair, followup of randomized trials, and use of biomarkers, are helping, as our interdisciplinary approaches. Ultimately, the promise of the field will be proven by preventive interventions that are developmentally appropriate and systems based.