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 chronic disease epidemiology, 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.

Table of Contents

Foreword by Mervyn Susser; SECTION A - BACKGROUND; Chapter 1 - Introduction: a lifecourse approach to the aetiology of adult chronic disease; Chapter 2 - The life course and adult chronic disease: an historical prespective with particular reference to coronary heart disease; SECTION B - DEVELOPMENT OF DISEASE RISK THROUGHOUT LIFE; Chapter 3 - Preadult influences on cardiovascular disease and cancer; Chapter 4 - Diabetes and insulin action; Chapter 5 - Respiratory and allergic diseases; Chapter 6 - Blood pressure and hypertension; SECTION C - BIOLOGICAL AND SOCIAL PROCESSES; Chapter 7 - Fetal growth and development: the role of nutrition and other factors; SECTION D - EXPLAINING DISEASE PATTERNS; Chapter 9 - Time trends; Chapter 10 - Geography and migration; Chapter 11 - Socioeconomic differentials; SECTION E - IMPLICATIONS FOR POLICY AND FUTURE RESEARCH; Chapter 12 - Should we intervene to improve fetal growth?