Epigenetics is likely to play a role in the mediation of the effects of genes and environment in risk for many non-communicable diseases (NCDs). The Developmental Origins of Health and Disease (DOHaD) theory presents unique opportunities regarding the possibility of early life interventions to alter the epigenetic makeup of an individual, thereby modifying their risk for a variety of NCDs. While it is important to determine how we can lower the risk of these NCDs, it is equally important to understand how the public’s knowledge and opinion of DOHaD and epigenetic concepts may influence their willingness to undertake such interventions for themselves and their children. In this review, we provide an overview of epigenetics, DOHaD, NCDs, and the links between them. We explore the issues surrounding using epigenetics to identify those at increased risk of NCDs, including the concept of predictive testing of children. We also outline what is currently understood about the public’s understanding and opinion of epigenetics, DOHaD, and their relation to NCDs. In doing so, we demonstrate that it is essential that future research explores the public’s awareness and understanding of epigenetics and epigenetic concepts. This will provide much-needed information which will prepare health professionals for the introduction of epigenetic testing into future healthcare.

The field of epigenetics is currently one of the most rapidly expanding in biology and has resulted in increasing public interest in its applications to human health. Epigenetics provides a promising avenue for both targeted individual intervention and public health messaging. However, to develop effective strategies for engagement, it is important to understand the public’s understanding of the relevant concepts. While there has been some research exploring the public’s understanding of genetic and environmental susceptibility to disease, limited research exists on public opinion and understanding of epigenetics and epigenetic concepts. Using an online questionnaire, this study investigated the Australian public’s understanding, views, and opinions of epigenetics and related concepts, including the concepts of the developmental origins of health and disease (DOHaD) and the first 1000 days. Over 600 questionnaires were completed, with 391 included in the analysis. The survey included questions on knowledge of epigenetics and perceptions of epigenetic concepts for self and for children. Data were analyzed using predominately descriptive statistics, with free-text responses scored based on concordance with predetermined definitions. While participants’ recognition of epigenetic terms and phrases was high, their understanding was limited. The DOHaD theory was more accurately understood than the first 1000 days or epigenetics itself. Female participants without children were more likely to recognize the term epigenetics, while age also had an impact. This research provides a solid foundation for further detailed investigation of these themes, all of which will be important data to help inform future public health messages regarding epigenetic concepts.

Metabolic programming and metabolic imprinting describe early life events, which impact upon on later physiological outcomes. Despite the increasing numbers of papers and studies, the distinction between metabolic programming and metabolic imprinting remains confusing. The former can be defined as a dynamic process whose effects are dependent upon a critical window(s) while the latter can be more strictly associated with imprinting at the genomic level. The clinical end points associated with these phenomena can sometimes be mechanistically explicable in terms of gene expression mediated by epigenetics. The predictivity of outcomes depends on determining if there is causality or association in the context of both early dietary exposure and future health parameters. The use of biomarkers is a key aspect of determining the predictability of later outcome, and the strengths of particular types of biomarkers need to be determined. It has become clear that several important health endpoints are impacted upon by metabolic programming/imprinting. These include the link between perinatal nutrition, nutritional epigenetics and programming at an early developmental stage and its link to a range of future health risks such as CVD and diabetes. In some cases, the evidence base remains patchy and associative, while in others, a more direct causality between early nutrition and later health is clear. In addition, it is also essential to acknowledge the communication to consumers, industry, health care providers, policy-making bodies as well as to the scientific community. In this way, both programming and, eventually, reprogramming can become effective tools to improve health through dietary intervention at specific developmental points.

To a large extent the seeds of the global stock market crash in October lie in the Louvre accord established at the beginning of this year. As we argue below, this agreement was fatally flawed in attempting to fix the dollar at too high a level. This error was initially both masked and aggravated by the extensive use of official intervention as the means of supporting the dollar. By the end of the summer it is estimated that up to two thirds of the US current account deficit was ‘covered’ by official intervention.

Scarcely a year ago there was a good deal of discussion about whether the collapse in oil prices would bring about a boom in the world economy. Now there is widespread talk of a world recession. In both cases speculation is likely to prove unfounded. Recent pessimism has been associated with the effects of the dollar's depreciation and lower OPEC demand for manufacturing imports. We argue below that, while both factors could lead to a temporary slowdown in the aggregate level of world activity, they should not lead to a major world recession.

In the ‘overall outlook’ section we focus on the influence of the Group of Five (G5) ‘accord’ on exchange-rate prospects, and compare the expected impact of an appreciating currency on growth prospects in Japan and Germany. The short-term forecast is then discussed in more detail in sections covering the six major economies, commodity prices and trade. In the second half of the chapter we examine economic prospects in the world economy over the next five years, focusing particularly on the outlook for current balances. In our central medium-term forecast exchange rates move sufficiently to bring about a large, if not total, reduction in the present level of trade imbalance. Our forecast for a substantial fall in the US deficit is unusual, and we examine the key issues involved as well as looking at associated changes in the Federal budget deficit. Finally, we present two simulations which represent alternative routes to removing current account disequilibrium. The first involves substantial, and as yet unannounced, fiscal reflation in Japan and Germany, which is sufficient to broadly maintain current exchange-rate parities. By contrast, a second simulation illustrates a collapse in the dollar, and the consequences of exchange-rate overshooting.

Beginning with this Review, the World Economy chapter contains a number of changes in format and content. The first half of the chapter presents the main forecast, which for the first time is produced with the aid of a quarterly econometric model, GEM. The second half of the chapter will be devoted to one or more topical issues concerning the world economic outlook, using analysis based on econometric evidence or model simulations. In this Review we look at the prospects for the US current balance. An appendix briefly outlines the structure of GEM.