Developmental Origins of Health and Disease

(Professor Chong Yap Seng)

Professor Chong is the Dean of the NUS Yong Loo Lin School of Medicine (NUS Medicine), and the Executive Director of the Singapore Institute for Clinical Sciences, A*STAR (SICS). NUS Medicine and SICS have several ongoing joint research programmes, including cohort studies - Growing Up in Singapore Towards Healthy Outcomes (GUSTO) and Singapore PREconception Study of long Term maternal and child Outcomes (S-PRESTO).

This collaborative approach and shared access to resources made it possible to publish over 250 peer-reviewed publications (84 > IF5) and draw in industry contracts of over $27.9M. Together with the multi-national EpiGen consortium (New Zealand, United Kingdoms and Singapore), we partnered a reputable multi-national corporation and initiated the Nutritional Intervention Preconception and during Pregnancy to maintain healthy glucosE levels and offspRing health (NiPPeR), a multi-centre randomised control trial in 2014 (PI: A/P Chan SY). These programs are well positioned between academia and industry to catalyse translational research that will change tomorrow’s health, today.

Several important management mindset-shifts have occurred in response to the data uncovered in the course of the GUSTO study. The translational potential to impact public health policy in Singapore is demonstrated by the adoption of universal screening for gestational diabetes by the Ministry of Health in 2017 and uncovering the importance of maternal mental health, leading to the President’s Challenge awarding $200,000 over 2 years (2018-2019) for Promoting Parental Emotional Health to Enhance Child Learning, a social programme on mental mood. A second study conducted by SICS and NUH, named Mapping Antenatal Maternal Moods, kickstarted in 2018 as well. Public health messages drawn from interconnected research areas in allergy, nutrition and physical activity are one of the many possible achievements in the near future.

The Developmental Origins of Health and Disease (DOHaD) hypothesis proposes that several non-communicable diseases (NCDs) – including coronary heart disease, type 2 diabetes, and mental health illnesses – have their origins in prenatal life and in early childhood. One underlying principle within the DOHaD-field is that environmental, nutritional, hormonal and metabolic factors active during sensitive periods of development may permanently influence the health of the growing fetus and child.

As we uncover new discoveries to deepen our understanding on human health, 2018 marks GUSTO’s 10th year anniversary and signifies our debt of gratitude towards the participating mothers and children. The wealth of data awaits the researchers and spurs continued work as the cohorts grow with the research team. The unique study design in GUSTO allows for ongoing observations in the children in relation to metabolic and behavioral changes during puberty and adolescence as the next step. Aligned with the National Artificial Intelligence Strategy towards Smart Nation Singapore, advances in data and machine learning approaches will be tapped on. Evidence based informed public policy changes originating from Singapore datasets is one of the many leverages of these studies.