title: The environmental roots of non-communicable diseases (NCDs) and the epigenetic impacts of globalization.
abstract: BACKGROUND
  Non-communicable diseases (NCDs) are increasing worldwide. We hypothesize that environmental factors (including social adversity, diet, lack of physical activity and pollution) can become "embedded" in the biology of humans. We also hypothesize that the "embedding" partly occurs because of epigenetic changes, i.e., durable changes in gene expression patterns. Our concern is that once such factors have a foundation in human biology, they can affect human health (including NCDs) over a long period of time and across generations.
  
  
  OBJECTIVE
  To analyze how worldwide changes in movements of goods, persons and lifestyles (globalization) may affect the "epigenetic landscape" of populations and through this have an impact on NCDs. We provide examples of such changes and effects by discussing the potential epigenetic impact of socio-economic status, migration, and diet, as well as the impact of environmental factors influencing trends in age at puberty.
  
  
  CONCLUSIONS
  The study of durable changes in epigenetic patterns has the potential to influence policy and practice; for example, by enabling stratification of populations into those who could particularly benefit from early interventions to prevent NCDs, or by demonstrating mechanisms through which environmental factors influence disease risk, thus providing compelling evidence for policy makers, companies and the civil society at large. The current debate on the '25 × 25 strategy', a goal of 25% reduction in relative mortality from NCDs by 2025, makes the proposed approach even more timely.
  
  
  CONCLUSIONS
  Epigenetic modifications related to globalization may crucially contribute to explain current and future patterns of NCDs, and thus deserve attention from environmental researchers, public health experts, policy makers, and concerned citizens.
authors.affiliation: MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College, St. Mary׳s Campus Norfolk Place, W2 1PG London, United Kingdom; Human Genetics Foundation, Torino (HuGeF), Italy. Electronic address: p.vineis@imperial.ac.uk.
authors.forename: Paolo
authors.initials: P
authors.lastname: Vineis
authors.affiliation: Institute of Social and Preventive Medicine (IUMSP), Lausanne University Hospital, 1010 Lausanne, Switzerland.
authors.forename: Silvia
authors.initials: S
authors.lastname: Stringhini
authors.affiliation: Hospital del Mar Institute of Medical Research (IMIM), CIBER en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain; School of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: Miquel
authors.initials: M
authors.lastname: Porta
mesh_terms: D004194:Disease / Q000209:etiology*; D004777:Environment; D044127:Epigenesis, Genetic; D057890:Epigenomics; D006801:Humans; D038622:Internationality
keywords: Diet; Environmental epigenomics; Environmental pollutants; Socioeconomic status; Trade; Transgenerational hazards