According to the Developmental Origins of Health and Disease (DOHaD) hypothesis several non-communicable diseases (NCDs) have their origins in prenatal life and in early childhood. These NCDs include coronary heart disease, type 2 diabetes as well as several psychological outcomes and a variety of other health outcomes.
It is proposed that the intrauterine milieu affects the developing fetus via a number of pathways resulting in the programming of various health outcomes. The consequences of programming can be both positive and negative.
One underlying principle within the DOHaD-field is that factors including nutritional, hormonal and metabolic ones that are active during sensitive periods of development may permanently influence the health of the growing fetus, through programming. Programming in general refers to a process where an insult, taking place during a sensitive period of development, may have lifelong consequences, by affecting the structure and physiology of cells and organs.
Helsinki Birth Cohort Study, HBCS
(Also known as IDEFIX – IDentifying Early Factors In syndrome X)-study
Helsinki Birth Cohort Study (HBCS) is a unique birth cohort study including 13345 subjects born in Helsinki in 1934-44 in the epidemiological cohort. It is a longitudinal study cohort with data throughout the life span including prenatal life, childhood, adult life and old age. Besides extensive epidemiological data, over 2000 subjects have been randomly selected for a clinical part. The subjects have been followed up clinically for nearly two decades with extensive phenotypic data available including metabolic data, dietary information as well as other lifestyle data. Psychological factors including personality, depression and anxiety has also been focused upon. A GWAS has been performed on the HBCS clinical study cohort.
HBCS has been made possible by the unique child welfare and school healthcare system in Finland. We have been able to abstract data from birth records, child welfare clinic and school healthcare records. Data on growth, socioeconomic aspects and general health has been collected. This data has been linked with data obtained from different national health care registers (e.g. Death register, Care Register for Health Care) and with data from Statistics Finland.
One primary aim of the Helsinki Birth Cohort Study is to assess how growth and environmental factors acting during the life course are related to health in adult life. Our particular focus has been to study the early life origins of cardiovascular disease and its risk factors. We are also focusing our research interest upon cognitive function, psychological and behavioral outcomes as well as aging-related processes. Our main focus is to study factors associated with healthy aging and an optimal intrinsic capacity. In doing this we take into account adult lifestyle, socioeconomic factors and genetic factors.
There are more than 100 original publications based on findings in the HBCS. Findings from HBCS have recently been reviewed in Eriksson JG. Ann Med. 2016 Sep;48(6):456-467
Some research questions of importance include:
- Importance of early growth for later risk of type 2 diabetes and obesity.
- The long-term consequences of maternal overweight and obesity during pregnancy for offspring later metabolic and cardiovascular health.
- Gene-early environmental interactions in development of obesity and related metabolic diseases.
- Factors influencing physical functioning in later life from a life course perspective.
- The studying of longevity for a life course perspective.
- Long-term consequences of early life stress and later health.
- Importance of epigenetic factors in development of obesity and other metabolic outcomes.
- Importance of gut microbiota in development of cardio-metabolic outcomes.
The HBCS group has built upon an extensive national and internal network of collaborators that enables maximization of the resources for the epidemiological and genetic studies, but also for sharing of data and collaboration.
HBCS has been supported by grants from British Heart Foundation, Finska Läkaresällskapet, the Finnish Special Governmental Subsidy for Health Sciences, Academy of Finland, Samfundet Folkhälsan, Liv och Hälsa, Juho Vainio Foundation, Yrjö Jahnsson Foundation, The Diabetes Research Foundation, Finnish Foundation for Cardiovascular Research, the Signe and Ane Gyllenberg Foundation, EU FP7 (DORIAN) project number 278603, and EU Horizon 2020 (DynaHealth) project number 633595.