- DOHaD —
- Developmental Origins of Health and Disease
Well before Wordsworth, it was recognized that early life experiences shaped adult personality and behavior. However, until much more recently, the dominant medical model posited virtually a complete disconnect between childhood and adult health. It was as though emerging from childhood without major disease or disability miraculously reset the “health-o-meter” to 0, only to rebegin registering its scores in midlife. A quarter century ago, David Barker and colleagues showed the biological implausibility of such a simplistic model.1 Since then, accumulating evidence has strengthened the “Barker hypothesis” and now “developmental origins of health and disease,” or DOHaD, is an increasingly accepted concept.
Although acknowledgment that childhood, fetal, and even preconceptional events can influence later health is growing, skeptics remain, partly because the link is still largely based on association, not proven mechanisms of causation. Mechanistic research is urgently needed to convince naysayers and, more importantly, to devise treatments and preventions, for the many “adult-onset” conditions that actually are rooted in much earlier exposures and events.
An example of such mechanistic research …
Address correspondence to Alan E. Guttmacher, MD, 31 Center Dr, Rm 2A03, MSC 2425, Bethesda, MD 20892-2425. E-mail: