How is DOHaD influencing arrangement? Dr. Chessa Lutter Essential Counselor Santiago de Chile, November 19-22, 2009.


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. . How is DOHaD influencing strategy? Dr. Chessa Lutter Key Guide Santiago de Chile, November 19-22, 2009 What does it take for DOHaD to impact arrangement? Is there a reasonable measure of populace inferable danger (Standard) for wellbeing and the improvement of human capital ?
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. . How is DOHaD influencing strategy? Dr. Chessa Lutter Principal Advisor Santiago de Chile, November 19-22, 2009

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What does it take for DOHaD to impact arrangement? Is there an unmistakable measure of populace inferable danger (PAR) for wellbeing and the advancement of human capital ? Have intercessions been recognized that are viable and viable when conveyed through existing wellbeing and social administration stages? Do the intercessions address social disparities in wellbeing and human capital? Has there been a viable support method to impact significant specialized and political plans? Was the methodology successful?

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Epigenetics? Concordant formative changes in DNA methylation crosswise over chromosome 2 in two P21 versus P0 mouse hypothalamus MSAM cohybridizations Cohybridization 1 Cohybridization 2 Wenjuan Zhang civility of Robert Waterman

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It’s a FAT WORLD FAT Kids Urban puppy: excessively fat, making it impossible to walk? Urban wild bear behind fast-food eatery: the new love seat potato? FAT Daddys

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What extent of grown-up ailment is clarified by DOHaD versus nature in which we live and eat and move (or don’t move enough)? Formative beginnings of grown-up illness Obesigenic environment Interaction ? Wenjuan Zhang politeness of Robert Waterman

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Severe intense ailing health Stunting 8.1 cm Marasmas Kwashiorkor Age: 2 y 9 m Weight: 10.7 kg. Tallness: 78.3 cm 2 y 6 m 11.6 kg 86.4 cm Photo credit: Lancet Photo credit: UNICEF, Perãº

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Critical period to counteract straight development hindrance 0.5 0 - 0.5 - 0.5 - 1 - 1 - 1.5 - 1.5 - 2 - 2 - 1 + 2 years - 1 y + 2 Z - 2.5 0 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49 51 53 55 57 59 Age (months) Africa Latin America and Caribbean Asia Source: Shrimpton, R. et al, 2001. http://www.pediatrics.org/cgi/substance/full/107/5/e75

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Prevalence of hindering to low weight for age (<- 2 DS) in kids < 5 years % 3.0 6.2 4.5 Source : OPS. Desnutriciã³n en Infantes y Niã±os Pequeã±os en Amã©rica Latina y El Caribe: Alcanzando los Objetivos del Desarrollo del Milenio. Washington: 2008

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Distribution of Z scores of Guatemalan youngsters < 5 years (2002) Weight/age Weight/Length/age Obese Stunted

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Tendencies in the commonness of hindering, by nation and year of study 2008 1989 1994 1998 2003 1986 1995 2000 2005 1986 1991 1996 2002 1987 1995 1999 2002 1995 2000 2005 1986 1996 2000 2007 Source: OPS. Malnutriciã³n en infantes y niã±os pequeã±os en Amã©rica Latina y El Caribe: Alcanzando los Objetivos de Desarrollo del Milenio. Washington DC. 2008

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Prevalence of hindering by year of study and maternal training =59.3% =62.3% Source: OPS. Malnutriciã³n en infantes y niã±os pequeã±os en Amã©rica Latina y El Caribe: Alcanzando los Objetivos de Desarrollo del Milenio. Washington DC. 2008

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Short-term outcomes Mortality, dreariness, incapacity Long-term results: Adult size, scholarly capacity, monetary profitability, regenerative execution, metabolic CHD Maternal and youngster undernutrition Immediate reasons Inadequate dietary admission Disease Household sustenance shakiness Unhealthy hh environment & absence of wellbeing administrations Inadequate consideration Income neediness: Employment, independent work, staying, resources, settlements, benefits, exchanges, and so forth Underlying reasons Lack of capital: money related, human, physical, social, and characteristic Basic reasons Social, financial, and political connection UNICEF Conceptual model

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The part of irresistible illness in kid development Source: Mata L. The Children of Santa Maria Caique, 1983.

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Policy driver: The impact of hunger and human capital The causal relationship in the middle of neediness and lack of healthy sustenance The causal relationship in the middle of ailing health and destitution INCAP longitudinal study and work of Reynaldo Martorell

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Decline in the predominance of hindering in Brazil, 1996-2006 half 1996 2006 Source: Monteiro et al., Causes for the decrease in tyke undernutrition in Brazil, 1996-2007 Rev Saude Pãºblica 2009;43(1)

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Explanatory variable for the decrease in hindering in Brazil, 1996-2006 =63.3% Source: Monteiro et al., Causes for the decrease in kid undernutrition in Brazil, 1996-2007 Rev Saude Pãºblica 2009;43(1)

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Breastfeeding Photo credit: Joã£o Aprigio Guerra de Almeida, Fundaciã³n Fiocruz, Brasil

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Breastfeeding advancement refered to as the best preventive intercession to keep under-5 mortality From Jones G, Steketee RW, Black RE, Bhutta ZA, Morris SS, Bellagio Child Survival Study Group. What number of youngster passings would we be able to keep this year? The Lancet 2003; 362: 65-71.

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The significance of wellbeing specialist preparing and advising on select breastfeeding 3 months 5 months 10-180 days 6 months % Source: OPS. Malnutriciã³n en los niã±os pequeã±os en Amã©rica Latina y el Caribe: Alcanzando los Objetivos de Desarrollo del Milenio. Washington 2008.

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Effects on human capital improvement Washington Post 2002; Mortenson et al., 2002 WHO. Horta et al., Geneva 2007. www.who.int/child_adolescent_health/archives/9241595230/en/index.html

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Policies and projects to bolster breastfeeding International Code of Marketing of Breast-milk Substitutes (WHO 1981) Innocenti Declaration (1990) and support at the 45 th World Health Assembly Baby Friendly Hospital Initiative (WHO/UNICEF,1992) Capacity improvement in clinical administration of normal BF issues (USAID financed Wellstart International, 1983-1998) Global Strategy for Infant and Young Child Feeding and approbation by the World Health Assembly (2003) WHO Child Growth Standards (2006)

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Changes in medium term of breastfeeding: Latin American and Caribbean nations, 1986-2004 17.3 21.6 20.6 14 19.6 20.3 Months 19.9 16.2 20.6 11.8 21.6 9 Country

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Porcentaje de gasto all out (%) y gasto (US$) en la promociã³n de LM comparado an otros temas en nutriciã³n materno-infantil, 1999-2005 Fuente: Academy for Educational Development. LINKAGES Final Report. Washington DC: 2006. (Uses are balanced for expansion utilizing the Gross Domestic Product Implicit Price Deflator of 2000).

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What have we learned and what do regardless we have to know? 0.5 0 - 0.5 - 0.5 - 1 - 1 - 1.5 - 1.5 - 2 - 2 Maternal nourishment ? - 1 y + 2 - 1 + 2 years Z - 2.5 0 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49 51 53 55 57 59 Age (months) Africa Latin America and Caribbean Asia Source: Shrimpton, R. et al, 2001. http://www.pediatrics.org/cgi/substance/full/107/5/e75

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What does it take for DOHaD to impact approach? Is there a reasonable measure of populace inferable danger (PAR) for wellbeing and the improvement of human capital ? Have mediations been recognized that viable and viable when conveyed through addressing so as to exist wellbeing and social administration stages or central political and social disparities? Do the mediations address social imbalances in wellbeing and human capital? Has there been a successful support method to impact applicable specialized and political motivation? Was it su

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