The Developmental Origins of Health and Disease (DOHaD); an opportunity to profile Canadian health research on the global stage and to build partnerships with government and communities.

Preamble

The Developmental Origins of Health and Disease (DOHaD) is concerned with understanding factors that impact human developmental trajectories and predispose to later life disease. The DOHaD paradigm underlies much of neurobehavioral development and early obesity in children and the global epidemic in non-communicable disease (NCD). Understanding these relationships was the subject of a political declaration of the high-level meeting of the General Assembly of the United Nations (September 2011) on the Prevention and Control of non-communicable disease. The United Nations General Assembly recognized that many non-communicable diseases are inherently preventable.

Globally, many countries and regions have DOHaD Chapters, linked together through the International DOHaD Society. The International Society is currently based in the UK. Canada is particularly strong in this area of health research and DOHaD Canada has more than 350 members, including trainees. CIHR chose to focus attention on the DOHaD approach to improving health with the Healthy Trajectories Initiative (HeLTI), developed under Dr. Shoo Lee's leadership of the Institute of Human Development, Child and Youth health (IHDCYH).

The first World Congress in DOHaD took place in 2001 in Mumbai, and Congresses have been held subsequently every two years. Canada last hosted the International DOHaD meeting in Toronto in 2005. The 12th World Congress had initially been planned for October 2021 in Vancouver BC. Given the likely negative impact that the COVID19 pandemic would have on registration numbers, program quality, and sponsorship support, the Congress was moved to August 27-31, 2022, but still based in Vancouver. It will be preceded by integrated satellites on DOHaD in animal production, to be held in Quebec City in the fall of 2021, and a second satellite on DOHaD and Indigenous health, to be held in Kananaskis or Canmore, in mid-August 2022. Reports from each of these satellites will inform specific symposia at the Vancouver Congress.

In 2022, the DOHaD Congress will be held in conjunction with the Annual meeting of the Kids Brain Health Network (KBHN) in its third cycle as a Canadian Network of Centres of Excellence (NCE). DOHaD and KBHN share many scientific and policy goals in common with each other. The leaderships of both organisations welcome the opportunity to bring trainees and investigators from each group to the same integrated Congress.

As a precursor to the World Congress, the Canadian Academy of Health Sciences is committing its 2021 Forum in Montreal to “ Healthy Start; Life-long impact, Eradicating non-communicable Disease”

Background

The paradigm of Developmental Origins of Health and Disease (DOHaD) refers to adaptations during development that predisposes an individual or a population towards later life non-communicable disease conditions.  The developmental trajectory of an individual is determined substantially by the interaction between that individual’s genes with environmental influences. These may include maternal or paternal factors, nutritional deficits, toxic stress (including during a pandemic), and exposure to contaminants, drugs or alcohol, that occur before or around the time of conception, during pregnancy, or in the period after birth, the so-called first 1000 days. These interactions of genetics and environment determine developmental trajectories, mental health, brain development, learning, and behavioural patterns in early life.  In children and adolescents, developmental programming contributes to obesity, Type II diabetes, altered immune responsiveness, behavioural and neurological conditions, and in later life increases the risk of hypertension and heart disease.

The mechanisms underlying developmental programming include epigenetic modification of gene expression, structural changes in tissues or organs, effects on germ cells or stem cells, alterations in the microbiome or in core inflammatory processes.  There are clear sex differences in these responses, strong intergenerational effects, and variable vulnerability across the life course.

The Congress will discuss new ways of predicting predisposition to non-communicable conditions and apply that knowledge to the early diagnosis, intervention, and prevention of non-communicable conditions, particularly neuro-behavioural development in newborns, children, adolescents and youth across socio-economic groups. The focus will be on societal and environmental impacts. The discussion will apply to Indigenous and immigrant populations as well as non-Indigenous Canadians, to inform proposals for altered practice and government policy. 

Based on recent experiences, but recognising the unknowns of the post-COVID19 environment, we anticipate attracting approximately 1200-1500 delegates to the Congress. Historically, about one-third of registrants will be trainees. The Congress will attract world leaders in early child development, and a significant number of early- and mid-career investigators from low- and middle-income countries. The bid document is committed to providing free registrations for up to 100 LMIC early-career attendees.  The international characteristic of the Congress is proven; at the 2019 Congress in Melbourne, Australia, delegates came from more than 40 countries around the world.

Vancouver was chosen as the site for the DOHaD 2022 World Congress for many reasons, including its easy access from major international hubs in Europe, Australasia, North and South America, its reputation as one of the world’s best and safest cities, and its concentration of major centres with experts and trainees conducting world-class translational research programs in fetal, newborn and childhood development.

The Program and Executive Committee is co-chaired by University Professor Emeritus John Challis FRSC of the University of Toronto, also an Adjunct Professor at SFU and Professor Janice Bailey of Laval University and the Fonds recherche du Quebec. Further details of the organising committee structures and composition can be found here.

Program Outline

The overall theme of the 2022 DOHaD World Congress will be “Social and Environmental Disruptions in DOHaD; Successful Interventions for a Healthy Future”.

 The Congress will last 5 days. The first 2 days will focus primarily on activities organised by trainees, the following 3 days will make up the substance of the main Congress. The Congress program will have a major strength in face to face presentation, but will also include some virtual session opportunities, with live streaming and other hybrid components including later session viewing through video webinar and chat format. We are mindful of the need to accommodate different time zones around the world in organising virtual components of the program.

Delivery of the Congress themes will include keynote lectures, symposia, and free oral and poster communications. Topic areas will include core developmental processes, the microbiome, developing immune responses, and aspects of modifications in neurological and behavioural development.  Sub-themes running throughout the meeting will include discussion of the underlying mechanisms (genetic, epigenetic) determining developmental trajectories of children: implications for vulnerable populations, First Nations, Inuit, Metis, and new immigrants; the importance of the maternal and paternal pre-pregnancy environment; social inequities; climate and environmental change including food and water security; and integrating quality information and best practices to optimize children’s development and inform public health policy.

The Congress will feature 4 named lectures; The David Barker and Nick Hales Award lectures of the International DOHaD Society (selected by the International Council), The Fraser Mustard lecture of KBHN (selected by KBHN), and the DOHaD President's Lecture.

The Congress will place a strong emphasis on trainees. The trainee committee is developing an outstanding program to including sessions on implementation science, research methods, public policy, integrative communication in health research, machine learning, artificial intelligence, grant/fellowship writing, EDI, and networking.

Trainees will serve as co-chairs of scientific sessions, participate in symposia throughout the Congress and present their work in a special trainee award and plenary session each day. The main Congress will program plenary sessions with world-renowned keynote lecturers (see above), the highest-scoring abstracts (on peer review) by trainees, and 6 simultaneous sessions of symposia and oral presentations. We anticipate receiving around 600-700 additional abstracts that will be presented as posters, accessible throughout the meeting, with short (max. two minutes) presentations, judged by a panel that includes peers. We are developing an ambitious outreach program that will include debates, panels, a policy forum, public lectures, and connection corners for trainees.