1. What other non epigenetics evidence we already know? Content

2. Evidence on Health

3. In 1962 Professor James Neel suggested 'thrifty genes hypothesis‘ as the resolution to obesity problem. Thrifty genotype would have been advantageous for hunters gatherers, it allowed them to fatten more quickly during times of abundance. Fatter individuals carrying the gene survived better in times of food scarcity. In modern societies with abundance of food, this genotype efficiently prepares individuals for a famine that never comes. Result of this mismatch between environment in which we evolved & environment of today is a widespread chronic obesity & diabetes.

4. David Barker obituary Epidemiologist who proposed the idea that common chronic diseases result from poor nutrition in the womb 1938-2013

5. He challenged in 1995 the idea that chronic disorders are explained only by bad genes & unhealthy adult lifestyles. His 'Barker hypothesis' or "foetal programming hypothesis" proposed that the foetal environment & early infant health permanently programme body's metabolism & growth & thus determine pathologies of old age. He believed that public health medicine was failing, Its cornerstone should be the protection of nutrition of young women.

6. “Human beings are like motor cars. They break down either because of rough roads or because they were badly made in the first place”. “Rolls-Royce cars do not break down no matter where they are being driven”. “How do we build stronger people? By improving the nutrition of babies in the womb. The greatest gift we could give the next generation is to improve the nutrition & growth of girls & young women."

7. 2010

9. Inequality in early cognitive development of children in the 1970 British Cohort Study, at ages 22 months to 10 years IQ heritability 50-80%

10. Key messages from Marmot 2010 review 1.Social gradient on health inequalities is reflected in the social gradient on educational attainment 2. Focusing solely on the most disadvantaged will not reduce health inequalities sufficiently. 3. To reduce the steepness of the curve, actions must be universal, but with ‘proportionate universalism’. 4. Actions by central & local government, NHS, third & private sectors & community groups is required

11. Key Marmot recommendations 1.Give every child the best start in life 2.Increase investment in early years 3. Ensure high quality maternity services & parenting programmes 4.Ensure high quality childcare & early year’s education. 5. Build the resilience & well-being of young children

12. Evidence on Education

13. The Organisation for Economic Co-operation & Development (OECD) Centre for Educational Research & Innovation, 2006 report Considerable international evidence that education is strongly linked to health & to determinants of health such as health behaviours, risky contexts & preventative service use. A substantial element of this effect is causal. Education does not act on health in isolation. Income is another very important factor Empirical investigations often find that the effect of education on health is as great as that of income.

14. The wellness impact: enhancing academic success through healthy school environments report It reinforces the crucial link between quality nutrition, physical activity & academic performance. Brain imaging shows improved cognitive function in children & higher academic achievement after just 20 minutes of physical activity Breakfast eaters have better attention & memory than breakfast skippers

15. Health impact of education report, Institute of PH in Ireland 2008 Root causes of inequalities in education mirror those of health Improving educational outcomes amongst the most disadvantaged groups has the potential to make a positive impact on health inequalities.

16. Greater levels of education can lead to: – Improved chances of finding secure, well paid employment, with subsequent health benefits –More opportunities for social development & enhanced social skills, with –Positive impacts on individuals & wider community & subsequently for general health –Developing knowledge, attitudes & behaviours conducive to good health

17. A key common feature in the Nordic area is the respect accorded to & training required for those working with children in schools & early years Case study from England showed clearly that staff qualifications had a direct impact on children’s outcomes.