Developmental origins of health and disease – Global public health implications

• Leveraging health capital, even before conception, promotes resilience and reduces later dependency on health care.
• Biological and epigenetic processes operate across normal development, reflecting maternal health and lifestyle, and may provide biomarkers of NCD risk.
• Health literacy, lifestyle and physical fitness of couples, young adults and their children impact life-course health capital and that of the next generation.
• The Ob/Gyn community has a vital role to play in advocating and influencing health policy to deliver these messages.

The rapidly rising prevalence of non-communicable diseases (NCDs) represents a major challenge to public health and clinical medicine globally. NCDs are increasing rapidly in high-income countries, but even more rapidly in some low-middle-income countries with insufficient resources to meet the challenge. Whilst not identified in the Millennium Development Goals, there is much attention paid to NCDs in the discussions at many levels on the Sustainable Development Goals, as they underpin economic, social and environmental development in the post-2015 era. In this article, we discuss how a life-course approach to health, commencing of necessity in early development, can provide new opportunities for addressing this challenge. The approach can leverage human health capital throughout life and across generations. New insights into mechanisms, especially those processes by which the developmental environment affects epigenetic processes in the developing offspring, offer the prospect of identifying biomarkers of future risks. New interventions to promote health literacy, lifestyle and physical fitness in adolescents, young adults and their children hold great promise. In this respect, health-care professionals concerned with preconceptional, pregnancy and newborn care will have a vital role to play.