Hostname: page-component-78c5997874-v9fdk Total loading time: 0 Render date: 2024-11-18T02:19:50.258Z Has data issue: false hasContentIssue false

Just DO(HaD) It! Testing the clinical potential of the DOHaD hypothesis to prevent mental disorders using experimental study designs

Published online by Cambridge University Press:  30 August 2016

R. J. Van Lieshout
Affiliation:
Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
J. E. Krzeczkowski*
Affiliation:
Department of Health Sciences, McMaster University, Hamilton, ON, Canada
*
*Address for correspondence: J. E. Krzeczkowski, Department of Health Sciences, 1280 Main Street West, McMaster University, Hamilton, ON, L8S 4K1, Canada. (Email [email protected])

Abstract

Optimal early cognitive and emotional development are vital to reaching one’s full potential and represent our best chance to improve the mental health of the population. The developmental origins of health and disease (DOHaD) hypothesis posits that adverse perinatal exposures can alter physiology and increase disease risk. As physiological plasticity decreases with age, interventions applied during gestation may hold the most promise for reducing the impact of mental disorders across the lifespan. However, this vast clinical potential remains largely unrealized as the majority of human DOHaD research is observational in nature. The application of more rigorous experimental designs [e.g. Randomized Controlled Trials (RCTs)] not only represents a major step toward unlocking this potential, but are required to fully test the scientific validity of the DOHaD hypothesis as it pertains to mental illness. Here, we argue that the optimization of maternal diet and exercise during pregnancy represents our best chance to improve offspring neurodevelopment and reduce the burden of mental disorders. Follow-up studies of the offspring of pregnant women enrolled in new and existing RCTs of maternal gestational nutrition+exercise interventions are required to determine if acting during pregnancy can prevent and/or meaningfully reduce the prevalence and severity of mental disorders in the population.

Type
Review
Copyright
© Cambridge University Press and the International Society for Developmental Origins of Health and Disease 2016 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Kessler, RC, Berglund, P, Demler, O, et al. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the national comorbidity survey replication. Arch Gen Psychiatry. 2005; 62, 593602.Google Scholar
2. Costello, EJ, Foley, DL, Angold, A. 10-year research update review: the epidemiology of child and adolescent psychiatric disorders: II. developmental epidemiology. J Am Acad Child Adolesc Psychiatry. 2005; 45, 825.Google Scholar
3. Offord, DR, Boyle, MH, Szatmari, P, et al. Ontario child health study. Arch Gen Psychiatry. 1987; 44, 832836.CrossRefGoogle ScholarPubMed
4. Kim-Cohen, J, Caspi, A, Moffitt, TE, et al. Prior juvenile diagnoses in adults with mental disorder. Arch Gen Psychiatry. 2003; 60, 709717.Google Scholar
5. WHO. The world health report 2001: Mental Health: New understanding new hope, 2001. World Health Organization: Geneva.Google Scholar
6. Gandhi, S, Chiu, M, Lam, K, et al. Mental health service use among children and youth in Ontario: population-based trends over time. Can J Psychiatry. 2016; 61, 510.Google Scholar
7. Wang, PS, Lane, M, Olfson, M, et al. Twelve-month use of mental health services in the United States. Arch Gen Psychiatry. 2005; 62, 629640.CrossRefGoogle ScholarPubMed
8. Gluckman, PD, Hanson, MA, Cooper, C, Thornburg, KL. Effect of in utero and early-life conditions on adult health and disease. N Engl J Med. 2014; 359, 6173.CrossRefGoogle Scholar
9. Van Den Bergh BRH. Developmental programming of early brain and behaviour development and mental health: a conceptual framework. Dev Med Child Neurol. 2011; 53, 1923.Google Scholar
10. Heckman, JJ, Masterov, DV. The productivity argument for investing in young children. App Econ Perspect and Policy. 2007; 29, 446493.Google Scholar
11. Mervis, J. Past successes shape effort to expand early intervention. Science. 2011; 333, 952956.Google Scholar
12. Muennig, P, Robertson, D, Johnson, G, et al. The effect of an early education program on adult health: The Carolina abecedarian project randomized controlled trial. Am J Public Health. 2011; 101, 512516.CrossRefGoogle ScholarPubMed
13. Rolnick, A, Grunewald, R. Early childhood development: economic development with a high public return. The Region. 2003; 17, 612.Google Scholar
14. Levitt, P. Structural and functional maturation of the developing primate brain. J Pediatr. 2003; 143(Suppl. 4), S35S45.Google Scholar
15. Robling, M, Bekkers, MJ, Bell, K, et al. Effectiveness of a nurse-led intensive home-visitation programme for first-time teenage mothers (building blocks): a pragmatic randomised controlled trial. Lancet. 2016; 387, 146155.Google Scholar
16. Mendelson, T, Tandon, SD. Prevention of depression in childhood and adolescence. Child Adolesc Psychiatr Clin N Am. 2016; 25, 201218.Google Scholar
17. Burger, K. How does early childhood care and education affect cognitive development? An international review of the effects of early interventions for children from different social backgrounds. Early Child Res Q. 2010; 25, 140165.CrossRefGoogle Scholar
18. Cina, A, Röösli, M, Schmid, H, et al. Enhancing positive development of children: effects of a multilevel randomized controlled intervention on parenting and child problem behavior. Fam Sci. 2011; 2, 4357.Google Scholar
19. Anderson, LM, Shinn, C, Fullilove, MT, et al. The effectiveness of early childhood development programs: a systematic review. Am J Prev Med. 2003; 24(Suppl. 3), 3246.Google Scholar
20. Wachs, TD, Georgieff, M, Cusick, S, Mcewen, BS. Issues in the timing of integrated early interventions: contributions from nutrition, neuroscience, and psychological research. Ann N Y Acad Sci. 2014; 1308, 89106.Google Scholar
21. Campbell, FA, Ramey, CT, Pubgello, E, Sparling, J, Miller-Johnson, S. Early childhood education: young adult outcomes from the abecedarian project. Appl Dev Sci. 2002; 6, 4257.CrossRefGoogle Scholar
22. Olson, CM. Tracking of food choices across the transition to motherhood. J Nutr Educ Behav. 2005; 37, 129136.CrossRefGoogle ScholarPubMed
23. Erickson, MF, Aird, EG. The motherhood study: fresh insights on mothers’ attitudes and concerns. Children, Youth and Family Consortium, University of Minnesota, Minneapolis, MN. 2005.Google Scholar
24. Schlotz, W, Phillips, DIW. Fetal origins of mental health: evidence and mechanisms. Brain Behav Immun. 2009; 23, 905916.Google Scholar
25. Räikkönen, K, Pesonen, AK, Roseboom, TJ, Eriksson, JG. Early determinants of mental health. Best Pract Res Clin Endocrinol Metab. 2012; 26, 599611.CrossRefGoogle ScholarPubMed
26. Van Lieshout, RJ, Boyle, MH. Is bigger better? Macrosomia and psychopathology later in life. Obes Rev. 2011; 12, 405411.Google Scholar
27. Kim, DR, Bale, TL, Epperson, CN. Prenatal programming of mental illness: current understanding of relationship and mechanisms. Curr Psychiatry Rep. 2015; 17, 19.Google Scholar
28. Colman, I, Ataullahjan, A, Naicker, K, Van Lieshout, RJ. Birth weight, stress, and symptoms of depression in adolescence: evidence of fetal programming in a National Canadian Cohort. Can J Psychiatry. 2012; 57, 422428.Google Scholar
29. Colman, I, Ploubidis, GB, Wadsworth, MEJ, Jones, PB, Croudace, TJ. A longitudinal typology of symptoms of depression and anxiety over the life course. Biol Psychiatry. 2007; 62, 12651271.Google Scholar
30. Bale, TL, Baram, TZ, Brown, AS, et al. Early life programming and neurodevelopmental disorders. Biol Psychiatry. 2010; 68, 314319.Google Scholar
31. Rivera, HM, Christiansen, KJ, Sullivan, EL. The role of maternal obesity in the risk of neuropsychiatric disorders. Front Neurosci. 2015; 9, 116.CrossRefGoogle ScholarPubMed
32. Jacka, FN, Ystrom, E, Brantsaeter, AL, et al. Maternal and early postnatal nutrition and mental health of offspring by age 5 years: a prospective cohort study. J Am Acad Child Adolesc Psychiatry. 2013; 52, 10381047.Google Scholar
33. Keyes, KM, Davey Smith, G, Susser, E. Associations of prenatal maternal smoking with offspring hyperactivity: causal or confounded? Psychol Med. 2013; 44, 857867.Google Scholar
34. Golan, HM, Lev, V, Hallak, M, Sorokin, Y, Huleihel, M. Specific neurodevelopmental damage in mice offspring following maternal inflammation during pregnancy. Neuropharmacology. 2005; 48, 903917.Google Scholar
35. Ramsay, JE, Ferrell, WR, Crawford, L, et al. Maternal obesity is associated with dysregulation of metabolic, vascular, and inflammatory pathways. J Clin Endocrinol Metab. 2002; 87, 42314237.Google Scholar
36. Vucetic, Z, Kimmel, J, Totoki, K, Hollenbeck, E, Reyes, TM. Maternal high-fat diet alters methylation and gene expression of dopamine and opioid-related genes. Endocrinology. 2010; 151, 47564764.CrossRefGoogle ScholarPubMed
37. Sullivan, EL, Grayson, B, Takahashi, D, et al. Chronic consumption of a high-fat diet during pregnancy causes perturbations in the serotonergic system and increased anxiety-like behavior in nonhuman primate offspring. J Neurosci. 2010; 30, 38263830.Google Scholar
38. Gage, SH, Munafò, MR, Davey Smith, G. Causal inference in developmental origins of health and disease (DOHaD) research. Annu Rev Psychol. 2016; 67, 567585.CrossRefGoogle ScholarPubMed
39. D’Onofrio, BM, Class, QA, Lahey, BB, Larsson, H. Testing the developmental origins of health and disease hypothesis for psychopathology using family-based quasi- experimental designs. Child Dev Perspect. 2014; 8, 151157.CrossRefGoogle ScholarPubMed
40. Antoniou, EE, Fowler, T, Reed, K, et al. Maternal pre-pregnancy weight and externalising behaviour problems in preschool children: a UK-based twin study. BMJ Open. 2014; 4, e005974.Google Scholar
41. Chen, Q, Sjolander, A, Langstrom, N, et al. Maternal pre-pregnancy body mass index and offspring attention deficit hyperactivity disorder: a population-based cohort study using a sibling-comparison design. Int J Epidemiol. 2014; 43, 8390.Google Scholar
42. Class, QA, Rickert, ME, Larsson, H, Lichtenstein, P, D’Onofrio, BM. Fetal growth and psychiatric and socioeconomic problems: Population-based sibling comparison. Br J Psychiatry. 2014; 205, 355361.Google Scholar
43. Smith, GD. Assessing intrauterine influences on offspring health outcomes: can epidemiological studies yield robust findings? Basic Clin Pharmacol Toxicol. 2008; 102, 245256.Google Scholar
44. Christian, P, Mullany, LC, Hurley, KM, Katz, J, Black, RE. Nutrition and maternal, neonatal, and child health. Semin Perinatol. 2015; 39, 361372.Google Scholar
45. Macleod, J, Tang, L, Hobbs, FDR, et al. Effects of nutritional supplementation during pregnancy on early adult disease risk : follow up of offspring of participants in a randomised controlled trial investigating effects of supplementation on infant birth weight. PloS one. 2013; 8, 115.Google Scholar
46. Horan, MK, McGowan, CA, Gibney, ER, Donnelly, JM, McAuliffe, FM. Maternal low glycaemic index diet, fat intake and postprandial glucose influences neonatal adiposity – secondary analysis from the ROLO study. Nutr J. 2014; 13, 1.Google Scholar
47. Higgins, ST, Bernstein, IM, Washio, Y, et al. Effects of smoking cessation with voucher-based contingency management on birth outcomes. Addiction. 2010; 105, 20232030.Google Scholar
48. Escamilla-Nuñez, MC, Barraza-Villarreal, A, Hernández-Cadena, L, et al. Omega-3 fatty acid supplementation during pregnancy and respiratory symptoms in children. Chest. 2014; 146, 373382.Google Scholar
49. Karamoozian, M, Askarizadeh, G. Impact of prenatal cognitive-behavioral stress management intervention on maternal anxiety and depression and newborns’ Apgar scores. Iran J Neonatol. 2015; 6, 1423.Google Scholar
50. Tanvig, M, Vinter, CA, Jørgensen, JS, et al. Effects of lifestyle intervention in pregnancy and anthropometrics at birth on offspring metabolic profile at 2.8 years: results from the Lifestyle in Pregnancy and Offspring (LiPO) study. J Clin Endocrinol Metab. 2015; 100, 175183.Google Scholar
51. Sagedal, L, Øverby, N, Bere, E, et al. Lifestyle intervention to limit gestational weight gain: the Norwegian Fit for Delivery randomised controlled trial. BJOG. 2016; doi:10.1111/1471-0528.13862.Google Scholar
52. Thangaratinam, S, Rogozinska, E, Jolly, K, et al. Effects of interventions in pregnancy on maternal weight and obstetric outcomes: meta-analysis of randomised evidence. BMJ. 2012; 344, e2088e2088.Google Scholar
53. Van Lieshout, RJ. Role of maternal adiposity prior to and during pregnancy in cognitive and psychiatric problems in offspring. Nutr Rev. 2013; 71(Suppl. 1), 95101.CrossRefGoogle ScholarPubMed
54. Van Lieshout, RJ, Taylor, VH, Boyle, MH. Pre-pregnancy and pregnancy obesity and neurodevelopmental outcomes in offspring: a systematic review. Obes Rev. 2011; 12, 548559.Google Scholar
55. Monk, C, Georgieff, MK, Osterholm, EA. Research review: maternal prenatal distress and poor nutrition – Mutually influencing risk factors affecting infant neurocognitive development. J Child Psychol Psychiatry Allied Discip. 2013; 54, 115130.Google Scholar
56. Nyaradi, A, Li, J, Hickling, S, Foster, J, Oddy, WH. The role of nutrition in children’s neurocognitive development, from pregnancy through childhood. Front Hum Neurosci. 2013; 7, 97.Google Scholar
57. Georgieff, MK. Nutrition and the developing brain. Am J Clin Nutr. 2007; 85(Suppl), 614S619S.Google Scholar
58. Steenweg-de Graaff, J, Tiemeier, H, Steegers-Theunissen, RPM, et al. Maternal dietary patterns during pregnancy and child internalising and externalising problems. the Generation R study. Clin Nutr. 2014; 33, 115121.Google Scholar
59. Pina-Camacho, L, Jensen, SK, Gaysina, D, Barker, ED. Maternal depression symptoms, unhealthy diet and child emotional – behavioural dysregulation. Psychol Med. 2015; 45, 18511860.CrossRefGoogle ScholarPubMed
60. Bartholomew, S. What mothers say: The Canadian Maternity Experiences Survey. Public Health Agency of Canada, Winnipeg, Manitoba. 2009.Google Scholar
61. Grantham-McGregor, S, Baker-Henningham, H. Review of the evidence linking protein and energy to mental development. Public Health Nutr. 2005; 8, 11911201.Google Scholar
62. Tamura, T, Goldenberg, RL, Hou, J, et al. Cord serum ferritin concentrations and mental and psychomotor development of children at five years of age. J Pediatr. 2002; 140, 165170.Google Scholar
63. Hamadani, JD, Fuchs, GJ, Osendarp, SJM, Huda, SN, Grantham-McGregor, SM. Zinc supplementation during pregnancy and effects on mental development and behaviour of infants: a follow-up study. Lancet. 2002; 360, 290294.CrossRefGoogle ScholarPubMed
64. Murcia, M, Rebagliato, M, Iinguez, C, et al. Effect of iodine supplementation during pregnancy on infant neurodevelopment at 1 year of age. Am J Epidemiol. 2011; 173, 804812.Google Scholar
65. Leung, BMY, Wiens, KP, Kaplan, BJ. Does prenatal micronutrient supplementation improve children’s mental development? A systematic review. BMC Pregnancy Childbirth. 2011; 11, 1.Google Scholar
66. Smithers, LG, Golley, RK, Mittinty, MN, et al. Dietary patterns at 6, 15 and 24 months of age are associated with IQ at 8 years of age. Eur J Epidemiol. 2012; 27, 525535.Google Scholar
67. Theodore, RF, Thompson, JMD, Waldie, KE, et al. Dietary patterns and intelligence in early and middle childhood. Intelligence. 2009; 37, 506513.Google Scholar
68. Ong, ZY, Muhlhausler, BS. Maternal ‘junk-food’ feeding of rat dams alters food choices and development of the mesolimbic reward pathway in the offspring. FASEB J. 2011; 25, 21672179.Google Scholar
69. Oades, RD. Dopamine-serotonin interactions in attention-deficit hyperactivity disorder (ADHD). Prog Brain Res. 2008; 172, 543565.Google Scholar
70. Davies, GA, Wolfe, LA, Mottola, MF, C. M. Joint SOGC/CSEP clinical practice guideline: exercise in pregnancy and the postpartum period. Canadain J Appl Physiol. 2003; 28, 330441.Google Scholar
71. American College of Obstetricians and Gynecologists. Committee opinion: physical activity and exercise during pregnancy and the postpartum period. Obstet Gynecol. 2015; 26, 135142.Google Scholar
72. Clapp, JF, Simonian, S, Lopez, B, Appleby-Wineberg, S, Harcar-Sevcik, R. The one-year morphometric and neurodevelopmental outcome of the offspring of women who continued to exercise regularly throughout pregnancy. Am J Obstet Gynecol. 1998; 178, 594599.Google Scholar
73. Clapp, JF. Morphometric and neurodevelopmental outcome at age five years of the offspring of women who continued to exercise regularly throughout pregnancy. J Pediatr. 1996; 129, 856863.Google Scholar
74. Clapp, JF, Lopez, B, Harcar-Sevcik, R. Neonatal behavioral profile of the offspring of women who continued to exercise regularly throughout pregnancy. Am J Obstet Gynecol. 1999; 180, 9194.Google Scholar
75. May, LE, Scholtz, SA, Suminski, R, Gustafson, KM. Aerobic exercise during pregnancy influences infant heart rate variability at one month of age. Early Hum Dev. 2014; 90, 3338.Google Scholar
76. Labonte-Lemoyne, E, Curnier, D, Ellemberg, D. Foetal brain development is influenced by maternal exercise during pregnancy (poster). Presented at Neuroscience 2013, San Diego, CA, November 10, 2013.Google Scholar
77. Trull, TJ, Ebner-Priemer, UW. Ambulatory assessment. Eur Psychol. 2009; 14, 9597.Google Scholar
78. Dunton, GF, Liao, Y, Dzubur, E, et al. Investigating within-day and longitudinal effects of maternal stress on children’s physical activity, dietary intake, and body composition: protocol for the MATCH study. Contemp Clin Trials. 2015; 43, 142154.Google Scholar
79. Flynn, AC, Dalrymple, K, Barr, S, et al. Dietary interventions in overweight and obese pregnant women: a systematic review of the content, delivery, and outcomes of randomized controlled trials. Nutr Rev. 2016; 74, 312328.Google Scholar
80. Martin, JC, Zhou, SJ, Flynn, AC, et al. The assessment of diet quality and its effects on health outcomes pre-pregnancy and during pregnancy. Semin Reprod Med. 2016; 34, 8392.Google Scholar
81. Kuhlmann, AKS, Dietz, PM, Galavotti, C, England, LJ. Weight-management interventions for pregnant or postpartum women. Am J Prev Med. 2008; 34, 523528.Google Scholar
82. Adamo, KB, Ferraro, ZM, Goldfield, G, et al. The Maternal Obesity Management (MOM) Trial Protocol: a lifestyle intervention during pregnancy to minimize downstream obesity. Contemp Clin Trials. 2013; 35, 8796.Google Scholar
83. Sagedal, LR, Øverby, NC, Lohne-Seiler, H, et al. Study protocol: fit for delivery – can a lifestyle intervention in pregnancy result in measurable health benefits for mothers and newborns? A randomized controlled trial. BMC Public Health. 2013; 13, 132.Google Scholar
84. Poston, L, Briley, AL, Barr, S, et al. Developing a complex intervention for diet and activity behaviour change in obese pregnant women (the UPBEAT trial); assessment of behavioural change and process evaluation in a pilot randomised controlled trial. BMC Pregnancy Childbirth. 2013; 13, 116.Google Scholar
85. Whiteford, HA, Degenhardt, L, Rehm, J, et al. Global burden of disease attributable to mental and substance use disorders: findings from the Global Burden of Disease Study 2010. Lancet. 2013; 382, 15751586.Google Scholar
86. Bloom, DE, Cafiero, E, Jané-Llopis, E, et al. The Global Economic Burden of Noncommunicable Diseases. World Economic Forum: Geneva, 2011; pp. 1–46.Google Scholar