Taking a long look at healthy living

As we get better at living longer, the big question occupying health and medical researchers is how we remain healthy and happy across a longer lifespan.

Unlocking the secrets to living well as children, adults and in later adult life is the focus of three longitudinal studies at Deakin, placing the University at the centre of a global search for answers to some of our most pressing health concerns.

A key question for researchers at the SEED Centre for Lifespan Research is how the social environments that surround us as children and young people shape the rest of our lives.

Answers are being found through the Australian Temperament Project Generation 3 Study (ATPG3), one of Australia’s longest running intergenerational studies focusing on human health and development, and one of the few studies globally to have data across the human lifespan.

‘How we deal with emotions, the coping skills we need during times of stress or adversity are directly and indirectly taught through our relationships,’ Professor Olsson says.

Led by Deakin, the ATPG3 is a collaboration involving the Royal Children’s Hospital, Murdoch Children’s Research Institute and The University of Melbourne.

ATPG3 Scientific Director and NHMRC Leadership Fellow, Deakin Distinguished Professor Craig Olsson, says ATPG3 data is creating the clearest picture yet of the profound role that the social context plays in determining health and wellbeing.

‘Health and longevity emerge from unique combinations of the genes we inherit, the relationships we have, how well we manage our emotions, our cognitive reserves and the values that shape how we live our lives,’ Professor Olsson says.

‘What we learn and value, how we eat, sleep and exercise is modelled by and through our interactions with family, friends, partners, neighbours, colleagues, educators, coaches, mentors, health carers and the many other people we interact with on a regular basis within our communities.

‘How we deal with emotions, the coping skills we need during times of stress or adversity are directly and indirectly taught through our relationships.

‘Likewise, the values that determine how we treat ourselves and others as well as how we view the world more broadly don’t occur in a vacuum. They are largely transmitted through relationships across the life-course and across generations.

‘The quality of our social networks is where the rubber hits the road for health and longevity. It is what we call our relational health.’

The ATPG3 was an ambition born at the Royal Children’s Hospital in 1983 with the recruitment of more than 2000 babies and their parents. This cohort was followed every two or three years into young adult life when, in 2012, their babies were recruited into a new cohort study to examine intergenerational cycles of risk and adaptation.

At each wave, detailed information about social, emotional, and cognitive development has helped build a deeper understanding of generational transfer of risk and trauma and the relational pollutants likely to impact emotional health.

‘Our aim is to improve the health and wellbeing of future generations by helping shape the conditions that strengthen relationships within families, build better schools, more supportive workplaces and stronger communities,’ Professor Olsson says.

‘Our aim is quite simple: to add years to life and life to years,’ Professor Olsson says.

‘This year we begin the next major phase by bringing the first and second generations of parents and grandparents into sharper focus, looking at the pace-of-ageing in middle and later adulthood.

‘Taken together, all three generations are helping us identify the earliest opportunities to intervene in troubled pathways, to prevent harm, and build positive human development across the lifespan.

‘We have an unparallelled opportunity to unravel the secrets of longer healthier lives and inform research, public policy, and community practice. Our aim is quite simple: to add years to life and life to years,’ Professor Olsson says.

That same aim to improve the health of future generations motivated paediatrician and Deakin’s Chair in Medicine Professor Peter Vuillermin and his team to begin one of the world’s most successful birth cohort studies, the Barwon Infant Study (BIS), a partnership with Barwon Health and the Murdoch Children’s Research Institute.

From 2010, BIS recruited 1,074 mothers and their babies, following them for more than a decade. With a sharper biological focus, BIS is building understanding of the biological mechanisms and pathways through which modern environmental factors drive increasing rates of non-communicable diseases (NCDs).

BIS is looking for new ways to prevent some of the most common and important challenges in the modern world – food allergy and asthma, autism, attention deficit hyperactivity disorder, learning difficulties and increased cardiometabolic risk.

‘Our overarching hypothesis is that during early life, multiple modern environmental factors increase the risk of NCDs via unifying and targetable mechanistic pathways, including distorted immune development and oxidative stress,’ Professor Vuillermin says.

BIS is looking for new ways to prevent some of the most common and important challenges in the modern world.

BIS was the first human study to link the bacteria in the mother’s gut during pregnancy to an increased risk of preeclampsia, immune function in babies, risk of allergic disease and behaviour during early childhood.

BIS research has also linked exposure to plastic product chemicals during pregnancy with increased risk of autism and produced compelling evidence that a diet high in unprocessed foods – especially fruit, vegetables, fish and legumes – is associated with a whole range of health benefits, not just immune function but also brain development.

‘Building on BIS, our team now leads the world’s largest clinical trial of an intervention targeting microbiome-immune pathways for the prevention of asthma and allergic disease – ARROW,’ Professor Vuillermin says.

At the other end of the lifespan, the Deakin-led Geelong Osteoporosis Study (GOS) has spent the past three decades unpacking the mystery of how we age. With Barwon Health as a significant partner, it is one of a few large population-based cohort studies in Australia documenting changes to the health and wellbeing of young, middle-aged, and older women and men throughout the adult stages of life.

Initially focused on osteoporosis and bone health more generally, GOS now captures data related to the onset and progression of disorders including obesity, diabetes, cardiovascular disease, arthritis, sarcopenia, frailty, cognitive decline, and the links between physical and mental health.

IMPACT’s Professor Julie Pasco says more than three decades of findings from the study are being used across the world as the evidence base for national health campaigns, health modelling and further research.

‘The GOS-developed reference ranges for bone mineral density are used for clinically evaluating fracture risk in Australia,’ Professor Pasco says.

‘GOS has provided benchmark data for osteoporosis prevalence, underscoring national osteoporosis awareness campaigns and evidence for economic evaluation of the burden of disease in Australia. The GOS-developed reference ranges for bone mineral density are used for clinically evaluating fracture risk in Australia. Similarly, reference ranges were developed for lean mass and this data has been adopted internationally for identifying sarcopenia.

‘GOS was the first to report that systemic inflammation is a marker of increased skeletal fragility, that human bone metabolism is modulated by the β-adrenergic nervous system, and that extreme obesity increases the risk for fracture. This latter finding has been investigated more widely and is now being factored into a newer version of the international fracture risk tool known as the FRAX.’

Following the introduction of mental health diagnoses in 2004, GOS is now the most comprehensive longitudinal study of its kind in Australia, evaluating the interplay between somatic and psychiatric conditions.

‘We are developing a much deeper understanding of the relationship between mental and physical health and its links to the ageing process,’ Professor Pasco says.

‘So, it is not just a matter of eating a healthy diet and getting the right amount of exercise but managing stress levels and mental health in a comprehensive way.’

GOS began recruiting women from Geelong and the Barwon region in 1993. A new generation of younger women joined in the early 2000s and GOS now has around 700 continuing female participants aged between 39 and 91 years as well as around 650 male participants across a similar age range.

‘We know that a key factor in healthy ageing involves a combination of a person’s physical and mental capacities that they can draw on to maintain their functional ability into older age,’ Professor Pasco says.

Along the way, the lessons for healthy living are slowly being revealed.

‘We know that a key factor in healthy ageing involves a combination of a person’s physical and mental capacities that they can draw on to maintain their functional ability into older age,’ Professor Pasco says.

‘Avoid smoking and excessive alcohol intake, eat well, get adequate sleep and exercise, manage your existing health conditions, engage in social activities, and ensure you are taking the right medications.

‘Following this advice will help address problems with vision and hearing, promote physical activity, stimulate cognitive functioning, safeguard adequate nutrition, and support mental health.

‘And, as Professor Olsson’s work tells us, good health is also dependent on having people around us creating community.’

So, do these studies reveal the silver bullet to a long and happy life?

Professor Olsson cautions against thinking there is an easy answer except to say the people in our lives are at the heart of it all.

‘There are many silver bullets, and they sit across multiple systems of our lives, each contributing a bit to the overall, each a component cause of ageing well but all held together through the relational bonds we build with others,’ Professor Olsson says.

Find out more about Deakin’s latest health research.