From Womb to Tomb: A Life-Course Perspective on the Origins of Non-communicable Diseases.

Chronic illnesses such as diabetes, cardiovascular diseases, and respiratory disorders are leading causes of death globally. Although often considered adult-onset, growing evidence links their origins to early developmental exposures, including prenatal, neonatal, and early childhood stages. This review adopts a life-course perspective to examine how factors such as maternal undernutrition, gestational diabetes, low birth weight, early antibiotic use, suboptimal infant feeding, adverse childhood experiences, and childhood obesity influence long-term disease risk through mechanisms like epigenetic modifications, immune and hormonal programming, and metabolic changes. The window from conception through the first two years is especially critical for physiological programming. Evidence from cohort studies supports these associations, though findings are primarily drawn from high-income countries, limiting generalizability to more vulnerable settings. Despite awareness of early-life influence, most prevention remains adult-focused. There is a need for intergenerational strategies spanning preconception to early childhood, alongside school-based interventions and population-level policies. Mobile health technologies and personalized risk profiling offer scalable, cost-effective approaches to early intervention, particularly in underserved communities. The "womb-to-tomb" model emphasizes the urgency of investing in early health to achieve sustainable, equitable prevention of non-communicable diseases (NCDs) throughout life.