Researchers have shown that optimising early life nutrition can reduce the risk of adult cardiometabolic disease in genetically predisposed infants, thereby highlighting the promise of precision medicine in improving health outcomes.
Despite the implementation of public health campaigns, the burden of non-communicable diseases (NCDs) continues to rise worldwide. It has become increasingly apparent that more targeted preventative approaches are necessary to overcome this global health challenge.
Precision medicine involves tailoring medical interventions to an individual’s unique characteristics. It acknowledges the role of genetics and the environment as well as their interactions in human health and disease. This differs from the traditional ‘one-size-fits-all’ approach adopted by many public health campaigns.
Recent research has shown that adverse early-life environmental exposures place foetuses and infants on a trajectory towards poor health outcomes. Yet, not all individuals exposed to the same environmental factors develop diseases as an adult. This observation has implicated the role of genetics in the relationship between early life events and adult disease. Precision medicine can thus be used in early life to prevent the onset of NCDs later in life. By targeting intervention and prevention strategies to those who would benefit most, this approach could also save costs and resources.
Birthweight polygenic score
A recent study, published in Scientific Reports, assessed the interactions between genetics and early life nutrition and its effect on adult cardiometabolic health factors. A team of researchers, led by the School of Medicine and Public Health at University of Newcastle, genotyped 1,328 participants from the Raine Study. Based in Western Australia, the Raine Study is a longitudinal prospective cohort exploring pregnancy, childhood, adolescence and adulthood.
The researchers determined the birthweight polygenic score (BW-PGS) for each participant. Polygenic scores estimate how likely an individual is to have a given phenotype based on the cumulative effects of many genetic variants. Here, individuals with high BW-PGS were found to be genetically predisposed to high birthweight.
The BW-PGS was developed using the findings of a genome-wide association study meta-analysis conducted by the Early Growth Genetics consortium. The study had previously identified 60 single nucleotide polymorphisms associated with birthweight and adult disease.
Genetics, early life nutrition and long-term health
The researchers found that individuals with high BW-PGS received greater long-term health benefits from breastfeeding. They exhibited a 35% reduction in adult obesity incidence and a 50% reduction in having elevated systolic blood pressure with an increased duration of breastfeeding. Meanwhile, there was no significant association between cardiometabolic phenotypes and duration of breastfeeding in individuals with low BW-PGS.
The study also reinforced the importance of healthy nutrition beyond breastfeeding in the earlier years of life. The researchers revealed significant reductions in the risk of adult overweight/obesity and high systolic blood pressure in all infants fed with higher quality diets during the first year of life. In contrast, they did not observe a significant reduction in infants fed with high-quality diets in the first three years of life.
This study has provided evidence for early life precision medicine to reduce the risk of cardiometabolic disease in adulthood. Specifically, the results support a longer duration of breastfeeding for infants with high BW-PGS.
The first 1,000 days of life is when phenotypes, including adult health outcomes, are most susceptible to change depending on environmental exposures. Accordingly, this study demonstrates that providing quality nutrition during this critical period improves future health outcomes. Optimising nutrition for genetically predisposed individuals yields even greater benefits. In this context, the age-old saying “let food be thy medicine” has never been truer.
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