DOHaD in the Pacific: Connecting early-life factors and current health in Rarotongan adolescents

Abstract

Background/Aims: The Cook Islands, a small island developing state in Oceania with a population of 14,800, carries one of the highest burdens of non-communicable diseases (NCDs) globally. 80% of deaths are attributable to NCDs and overweight/obesity in adults has reached 91%/72%. The developmental origins of health and disease (DOHaD) paradigm can be used to understand associations between adverse early-life environmental exposures, such as during preconception and pregnancy, and later-life NCD risk. In order to reduce the high NCD rates and promote good health for future generations in the Cook Islands, we must understand the health of adolescents as they are the next generation of parents. This study explored the health status and early-life factors of the Year 9 student cohort in Rarotonga, Cook Islands for three years. Method: Annual school health assessments were undertaken from 2016-2019 with 538 Year 9 students in total, aged between 13-14 years. Measurements included weight, height, waist circumference, blood pressure, blood cholesterol and glucose levels. Based on adolescent cut offs, data were then categorised. Results: Overall, 36% of Year 9 students had a healthy BMI and 64% were overweight/obese. We also found concerning rates for central obesity risk, raised blood pressure, raised blood glucose and raised total cholesterol. We also found associations between these health data and risk factors in the early-life stages via birth records. Conclusions: This study highlighted several areas of concern for metabolic health in Rarotongan adolescents. As our future parents, it is crucial that we find ways to reduce risk not only for the individuals, but for the next generation. Future studies should build on this evidence and work towards supporting community empowerment to influence current and future health.