The capacity-load model of non-communicable disease risk: understanding the effects of child malnutrition, ethnicity and the social determinants of health

European Journal of Clinical Nutrition
Jonathan C K Wells

Abstract

The capacity-load model is a conceptual model developed to improve understanding of the life-course aetiology of non-communicable diseases (NCDs) and their ecological and societal risk factors. The model addresses continuous associations of both (a) nutrition and growth patterns in early life and (b) lifestyle factors at older ages with NCD risk. Metabolic capacity refers to physiological traits strongly contingent on early nutrition and growth during the first 1000 days, which promote the long-term capacity for homeostasis in the context of fuel metabolism and cardiovascular health. Metabolic load refers to components of nutritional status and lifestyle that challenge homeostasis. The higher the load, and the lower the capacity, the greater the NCD risk. The model therefore helps understand dose-response associations of both early development and later phenotype with NCD risk. Infancy represents a critical developmental period, during which slow growth can constrain metabolic capacity, whereas rapid weight gain may elevate metabolic load. Severe acute malnutrition in early childhood (stunting, wasting) may continue to deplete metabolic capacity, and confer elevated susceptibility to NCDs in the long term. The model can be appl...Continue Reading

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Citations

Nov 9, 2019·Nature Medicine·J Jaime MirandaJonathan C K Wells
Dec 19, 2018·Hypertension Research : Official Journal of the Japanese Society of Hypertension·Tuck Seng ChengC Mary Schooling
Sep 11, 2019·The American Journal of Clinical Nutrition·Rasmus WibaekGregers S Andersen
Feb 13, 2020·PloS One·Severine FrisonUNKNOWN wasting prevention Working Group Collaborators
Jan 29, 2019·Maternal & Child Nutrition·Victor O OwinoAlan A Jackson
Oct 30, 2020·European Journal of Clinical Nutrition·Mordechai ShimonovEyal Leibovitz
Mar 21, 2021·Diabetes·Gernot Desoye, Jonathan C K Wells
Aug 8, 2021·International Journal of Environmental Research and Public Health·Nir Y Krakauer, Jesse C Krakauer

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