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Environmental Factor, February 2013

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Lancet commentary targets non-communicable diseases

By Eddy Ball

NIEHS scientists and an international group of collaborators published a commentary about early-life prevention of non-communicable diseases (NCDs), in the Jan. 5 issue of the journal The Lancet. The findings are the outcome of a session held May 13, 2012, prior to the third annual international conference on Prenatal Programming and Toxicity (PPTOX III) in Paris (see story).

In their comment, lead author NIEHS Senior Advisor for Public Health John Balbus, M.D., and colleagues argue that much more attention is needed on early-life interventions, such as alleviation of poverty, optimization of nutrition, and reduction of toxic exposures, to curtail the increasing prevalence of NCDs, including diabetes, cardiovascular disease, and cancer.

NCDs in developing countries

“NCDs underlie almost two-thirds of all global deaths,” the authors wrote. NCDs have a disproportionate impact on the poorest and most vulnerable populations in low-income and middle-income countries, with the greatest exposure to such environmental contaminants as metals, pesticides, persistent organic pollutants, and chemicals.

“Substantial reductions of NCD risks could be achieved through the use of existing maternal-child health platforms, to educate mothers about both nutritional and environmental exposures, and to integrate the health promotion and disease prevention agendas within social and economic development efforts,” they argue.

According to the authors, many NCDs that develop in adulthood are rooted in epigenetic alterations caused by in utero and early childhood experiences, pointing to a window of susceptibility during development where interventions may have the greatest effect. “Early life interventions,” they maintain, “can [also] reduce the perception of blame that the individual’s own lifestyle has caused his or her disease.”

In addition to Balbus, NIEHS contributors included NIEHS/NTP Director Linda Birnbaum, Ph.D., Health Scientist Administrator Jerry Heindel, Ph.D., and grantee Philippe Grandjean, M.D.

Citation: Balbus JM, Barouki R, Birnbaum LS, Etzel RA, Gluckman PD, Grandjean P, Hancock C, Hanson MA, Heindel JJ, Hoffman K, Jensen GK, Keeling A, Neira M, Rabadán-Diehl C, Ralston J, Tang KC. 2013. Early-life prevention of non-communicable diseases. Lancet 381(9860):3-4.

Development is most important time to intervene to prevent disease

This slide from Heindel’s presentation in Paris emphasized that exposure prevention in early life can have a substantial impact on epigenetic alterations during fetal and childhood development that influence the risk of chronic disease later in life. (Photo courtesy of Jerry Jeindel)

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