About the DynaHEALTH project
The DynaHEALTH consortium was awarded €5.9 million in 2015 through the EU’s research and innovation programme (Horizon 2020), bringing together a critical mass of experts from across a range of disciplines. This included experts in epidemiology, clinical nutrition, physiology, genetics, epigenetics, metabolomics, biostatistics, econometrics, health care, European policy and knowledge management from 14 organisations in European countries.
The research approach was unique as it examined the risks of type 2 diabetes (T2D) in both a biological and psychosocial context, throughout the life-course. The consortium had access to 20 cohorts with data from 1.3 million individuals from pre-conception to 85 years old across eight European countries. The aim of the project was to investigate a life-course strategy to reducing the risks of obesity and the onset of T2D, acknowledging the following statistics:
- Life expectancy at birth for males was expected to increase by 7.8 years over the projection period, from 78.3 in 2016 to 86.1 in 2070. For females, life expectancy at birth was projected to increase by 6.6 years, from 83.7 in 2013 to 90.3 in 2070, implying a convergence of life expectancy between males and females.
- According to estimates from the WHO's Childhood Obesity Surveillance Initiative (COSI), around 1 in 3 children in the EU aged 6-9 years old were overweight or obese in 2010. This was a worrying increase on 2008, when estimates were in 1 in 4.
- Obesity is estimated to cost Europe €70 billion annually in healthcare costs and lost productivity.
- The OECD estimates that average healthcare expenditure for a person with obesity can be 25% higher than for someone of normal weight.
- According to the International Diabetes Federation, in the Europe region 66 million adults are estimated to have diabetes and this figure is predicted to rise to 81 million by 2045. For 2017, this equates to 1 in 11 adults with diabetes. There were estimated to be approximately 690,000 deaths due to diabetes in 2017.
- 1 in 6 births is affected by hyperglycaemia in pregnancy.
- Over one third of diabetes cases have not been diagnosed and are at a higher risk of developing harmful and costly complications.
What did we study?
The project explored how glycaemic health and psychosocial factors interact and vary throughout the life-course. It tested the concept of a Gluco-Psychosocial Axis (GPA), incorporating the factors and pathways determining glucose metabolism and insulin sensitivity with the neuroendocrine response to psychosocial stress into a single health indicator.
In order to establish a GPA measure, the project studied the cardiometabolic and ageing patterns related to social adversity, family demographics, gestational weight gain and obesity, and diseases such as gestational diabetes mellitus. The research enabled us to better understand and characterise the combined effects of glucose metabolism and psychosocial stress, which have a significant impact on individuals health and working ability as they age.
What were the results?
As well as highlighting that health inequality is a major factor, the project contributed significantly to the growing body of evidence suggesting that early intervention is critical in reducing the risks of obesity and T2D.
The project results and outputs were translated into three main Key Exploitable Results (KERs):
- The Life-Course Publications Map is a compilation of peer-reviewed papers published to disseminate the findings from the DynaHEALTH action. This innovative, interactive, web-based tool visually represents all evidence published, mapped across the life-course from conception through to old age.
- The GPA Life-course Model provides open-access software as a model for calculating an individual’s risk, in terms of gluco-psychosocial status, of unhealthy and inactive ageing. The software has the potential to be applied in future research and could have the potential to contribute to the development of a risk-based assessment tool for healthcare professionals.
- Policy Options for Reducing the Risk of Obesity and Type 2 Diabetes provide policymakers, healthcare professionals and local healthcare systems with a set of evidence-based options to address the window of opportunity for intervention between the age of 18 months to five years. The policy options also take into consideration the ‘whole systems approach’ to tackling childhood obesity and the wider context of health inequalities.