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Annu Rev Public Health. 2013;34:49-60. doi: 10.1146/annurev-publhealth-031912-114419. Epub 2013 Jan 7.

Intergenerational health responses to adverse and enriched environments.

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Department of Community Medicine and Rehabilitation, University of Umeå, SE-90187 Umeå, Sweden.


Health consequences of relative or absolute poverty constitute a definitive area of study in social medicine. As demonstrated in the extreme example of the Dutch Hunger Winter from 1944 to 1945, prenatal hunger can lead to adult schizophrenia and depression. A Norwegian study showed how childhood poverty resulted in a heightened risk of myocardial infarction in adulthood. In England, a study of extended impaired prenatal nutrition indicated three different types of increased cardiovascular risk at older ages. Current animal and human studies link both adverse and enriched environmental exposures to intergenerational transmission. We do not fully understand the molecular mechanisms for it; however, studies that follow up epigenetic marks within a generation combined with exploration of gametic epigenetic inheritance may help explain the prevalence of certain conditions such as cardiovascular disease, schizophrenia, and alcoholism, which have complex etiologies. Insights from these studies will be of great public health importance.

[Indexed for MEDLINE]

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