Promotion of long-term health in early life.

Abstract

Noncommunicable chronic diseases (NCDs) are on the rise in high-income countries, leading to substantial morbidity and mortality and contributing to increased resource demands and healthcare costs. Early-life exposures can initiate trajectories that culminate in NCDs later in life. Examples include the metabolic-endocrine pathway to obesity, diabetes, and cardiovascular diseases; the immune-mediated pathway to asthma and allergies; or the neurodevelopmental-psychological pathway to mental health problems. The interconnected trajectories involving microbiome composition, epigenetic signatures, nutrition, and psychological factors in early life can establish a basis for long-term health. While universal vaccination programs are in place to prevent infectious diseases, a coordinated effort to mitigate the rise of NCDs is missing. Examples of how to balance short- and long-term effects in early life include the use of appropriate medications, balanced healthcare interventions, optimized nutrition, and a nurturing care in early life. While these examples will not provide simple answers, they may stimulate important discussions and research into the overarching question: How can we deliver care in early life that achieves optimal short-term outcomes while promoting long-term health trajectories and well-being? While it is imperative to underscore the significance of subsequent periods to circumvent a deterministic conceptualization of a singular period as the primary catalyst for the development of physical and mental health, early life remains an underexploited window of opportunity fostering long-term health and mitigating the growing resource challenges faced by healthcare systems.