One of the most significant studies in health has just celebrated 65 years since it started, and it’s still going strong.

Over those 65 years, residents of the small town of Framingham in Massachusetts, USA, have been participating in long-term studies looking at heart disease and its causes.

By the mid-1950s, the number of middle-aged men succumbing to coronary heart disease was causing serious concern – not least when several world leaders developed it. The disease had been on the rise since the start of the 20th century and the Framingham Heart Study set out in 1958 to establish what was behind this.

The study initially recruited more than 5,000 men and women, nearly a fifth of the whole population of Framingham. The researchers collected data about each of the participants every two years using interviews, clinical examinations and laboratory tests. The data covered participants’ lifestyle and environment as well as looking at their health and genetic profiles. This helped to show the importance of not smoking, taking enough physical activity, treating high blood pressure, avoiding obesity and the importance of blood fats in preventing coronary heart disease.

By 1971 the study had recruited a second generation of participants and in 1994 it extended its recruitment to reflect the changing population resulting from an influx of South Americans. 2002 saw the recruitment of a third generation. Over time, the study was widened to include other diseases, notably type 2 diabetes and dementia.

There were similar studies going on elsewhere but none was quite so comprehensive or prolonged. The Framingham study resulted in many papers published in leading scientific journals, and the work was widely discussed in scientific societies worldwide, greatly influencing research, debate and health policy.

Indeed, the findings in this and the other studies changed the way doctors looked at illness. Previously, most doctors thought of an illness as being caused by germs. If the germs could be killed or prevented from spreading, the illness would be eliminated. The Framingham discoveries required a rethink. This resulted in the concept of ‘non-communicable disease’ to explain much of modern illness and highlighted the importance of what we as individuals could do to prevent these diseases, as well as transforming the public health agenda.

There are questions over the future of this study, and whether it will continue to bring sufficient returns on the cost now that its primary objectives have been achieved. The US government has cut substantially its share of the funding.

But the fact remains that this study generated a novel way of looking at all disease and increased phenomenally our understanding of coronary heart disease.

About the study:  http://www.framinghamheartstudy.org/about/

 

“Non-communicable diseases” are those – such as heart disease, diabetes, cancer and lung disease – which arise from lifestyle and environmental factors rather than from germs and infections. Before the 20th Century, most deaths were due to infectious diseases. Now, nearly two-thirds of deaths worldwide are due to non-communicable diseases.

Tackling this presents an enormous challenge globally. A United Nations meeting in New York in 2011 identified the four major factors that we all need to address: poor diet, physical inactivity, tobacco use and alcohol intake.

But persuading adults to change their lifestyle is far from the whole picture. There is growing evidence that we also need to focus attention on children – and even on babies before they are born!

Some of these diseases have their roots in childhood. Coronary artery disease is one that has been extensively investigated. Many of the risk factors can be shown to have their onset in childhood, when dietary and other habits begin to form under the influence of family members and childhood friends. Parents need better information on the importance of encouraging physical activity and a good diet in their children.

A recent article in The Lancet* goes further and suggests that disease in later life can be affected by what happens to us before we are born. For example, if the mother is poorly nourished or has diabetes, this is associated with her unborn child being at greater risk of developing non-communicable diseases when it reaches adulthood.

There is also some evidence that if a pregnant mother or infant is exposed to certain pollutants in the atmosphere or in food, this too may have an impact on the child in the long term, potentially affecting its immune responses and its neurological and reproductive functions when adult. How this happens probably relates to changes in the way the baby’s DNA is processed during its development, when substantial changes can be passed from cell to cell as they divide and grow. These changes can last and have a knock-on effect in adult life.

These findings add to the urgent need for worldwide action to curb environmental pollution from harmful chemicals.

 

 

*Link to article: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)61609-2/fulltext?rss=yes

© 2012 How to Live to 110 Suffusion theme by Sayontan Sinha