29 Mar Preconception health – preventing disease before it occurs
Even with the advances of modern medicine, the world is getting sicker – obesity, non-communicable diseases, infertility and pregnancy complications are on the rise [1, 2]. The WHO has recently released it’s ‘Top 10 Threats to Public Health’ – which includes non-communicable disease, fragile and vulnerable groups such as maternal & child health, and poor primary health care – in their list . Furthermore, they recommended that integration and strengthening of ‘current guidance for preconception and antenatal care’ will enable communities to reduce non-communicable disease and childhood obesity . The preconception period has been recognised as an under‐appreciated time ‘in the life-cycle with far‐reaching consequences across the life course,’ and The Lancet released a three-part series campaigning for the benefits of preconception health. They noted that at least 50% of pregnancies are unintended or mistimed, and that having a narrow definition of preconception (time from intention to conceive to actual conception) resulted in many people not receiving the best preconception health advice. It was also commented upon, that the health of men is also underrepresented in much of the existing preconception literature, although it is starting to become apparent the health of both male and female partners can impact on their child’s well-being – in both good and bad ways . Given that our preconception health is a critical indicator to pregnancy outcomes with the consequences of one’s preconception health impacting on many future generations , it is vital that everyone receives quality, evidence based health and lifestyle advice, care and education.
As a global community, we need to start preventing these diseases before they even occur – a life-course approach to health that starts in school and continues into older adulthood. One way we can do this is by nurturing our microbiome (the multiple communities of bugs that live in various areas of our body), well before we’ve even started to contemplate having children. During the last decade the human microbiome has established itself as a key contributor to human health, particularly in the Developmental Origins of Health and Disease (DOHaD) . Eating healthy, home-cooked meals, daily exercise and looking after ourselves are all simple strategies that tend to get lost in the chaos that is modern society. It is well established that healthy parents make healthy babies, and we now know that development of a person’s microbiome begins well before birth, and has the ability to exert effects on the next generation [6-8]. In order to minimise, and ultimately halt disease progression and create healthier outcomes for future generations, we as individuals need to start focusing on our health and lifestyle – before we think about having children. We must start to look at preconception care as a ‘life-course’ approach, that begins as adolescents, and is maintained forever.
To read more about how you can improve your health (and the health of your children) head to The Lancet’s series on Preconception Health here. ‘No obesity strategy, no undernutrition strategy, no non-communicable diseases strategy, and no adolescent health strategy [should occur] without including preconception health’ .
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1. Department of Health, National Womens Health Strategy 2020-2030 (CONSULTATION Draft), D.o. Health, Editor. 2018, Australian Government: Canberra.
2. World Health Organisation (WHO). 10 Threats to Global Health. 2019 [cited Mar 29 2019]; Available from: https://www.who.int/emergencies/ten-threats-to-global-health-in-2019.
3. World Health Organization (WHO), Report of the commission on ending childhood obesity. 2016, World Health Organization: Geneva, Switzerland.
4. The Lancet, Campaigning for preconception health. The Lancet, 2018. 391(10132): p. 1749.
5. Stephenson, J., et al., Before the beginning: nutrition and lifestyle in the preconception period and its importance for future health. The Lancet, 2018. 391(10132): p. 1830-1841.
6. Stiemsma, L.T. and K.B. Michels, The Role of the Microbiome in the Developmental Origins of Health and Disease. Pediatrics, 2018. 141(4): p. e20172437.
7. Dominguez-Bello, M.G., et al., Role of the microbiome in human development. Gut, 2019: p. gutjnl-2018-317503.
8. Nuriel-Ohayon, M., H. Neuman, and O. Koren, Microbial Changes during Pregnancy, Birth, and Infancy. Frontiers in Microbiology, 2016. 7(1031).