An enormous research project will begin in the Hunter in January with the aim of improving lifespan through optimising health from conception.
Professor Craig Pennell, of the University of Newcastle's School of Medicine and Public Health, will lead the Newcastle 1000 project.
The aim is to recruit 1000 Newcastle families every year at the start of pregnancy for a decade.
"We'll have 10,000 Newcastle families that we'll be following for life," said Professor Pennell, a Hunter Medical Research Institute senior researcher who specialises in the "developmental origins of health and disease".
Decades of research has shown the environment [everything outside of DNA] in the first 1000 days from conception puts people on "trajectories to health or disease".
This means it's possible for interventions in this period to prevent diseases such as obesity, hypertension, diabetes, high cholesterol, heart disease, allergies, poor mental health and cancer.
"The most exciting thing is this window of opportunity to change the trajectory," Professor Pennell said.
"The first 1000 days of life, from conception to two years of age, offers a unique period where it's possible to set a course for lifelong health."
The researchers will seek to positively change the environment in early life and study the implications in childhood, young adulthood and adulthood.
The focus will be on "early nutrition, breastfeeding and parent-infant bonding - both mother-infant and father-infant bonding".
Research shows that environmental changes have a greater effect in people who are at high genetic risk for various diseases.
"We can target people's early nutrition based on their individual genetics," he said.
Interventions can be targeted to those likely to get the biggest benefit. This personalised medicine reflects the old saying "prevention is better than the cure".
"We strongly believe that prevention is the way to reduce adult disease," he said.
Globally, the rates of obesity, hypertension and diabetes continue to rise, despite massive public health campaigns.
"We need to do things better," he said.
"Our argument is we need to focus on the first 1000 days of life, which is when there is the greatest ability for the human body to manipulate its trajectory for the future."
Preliminary work examined those with a high genetic risk for obesity and high blood pressure. Extensive breastfeeding during early childhood reduced such risk to normal.
Professor Pennell said public health messages that "everybody should breastfeed, everybody should have a healthy diet" don't work.
"What we're suggesting is we would provide specific support programs for those people with the highest risks, to see if we can reduce adult disease," he said.
Research shows modest exercise in pregnancy has benefits. Too much exercise in pregnancy isn't good and neither is doing nothing.
"One of the things we'll be assessing in this study will be exercise in pregnant mothers and outcomes in the children," he said.
"We'll be able to look at maternal diet during pregnancy and the outcomes in children."
They'll also examine drugs, alcohol, smoking and "the impact that has on children and young adults".
The genomics of each individual will also be examined, taking the research to another level.
In the short term, the focus will be on childhood.
"Fortunately cancer - for example - doesn't typically happen until your 30s, 40s, 50s, but there are early markers of lots of cancers.
"Childhood obesity and blood pressure are very much linked to adult disease."
He added that there was good evidence that the "early environment has the ability to influence the development of allergies".
"People who are exposed to allergens, nuts and other things in very early childhood tend not to develop allergies to those things."
An allergy and immunology research group will be among the "30 or so research groups that will be working the Newcastle 1000".
"It's an enormous project that's called a cohort study. Another way of looking at it is life-course health."
The professor thinks of it like an equaliser in an old-school sound system.
"Very early in life, your equaliser is set," he said.
"Early in life, there's the ability to reset the equaliser by changing the environment and that's what we're trying to do in human populations."
The study will seek to recruit about a quarter of families involved in the 4500 or so deliveries at John Hunter Hospital each year.
It will follow mother, father and baby from the start of pregnancy until adult life.
Professor Pennell said Newcastle's population was committed to health and research.
"We feel confident we'll have lots of families who want to be engaged in this kind of research project," he said.
"One of the interesting things we know is families who engage in research actually have better health outcomes."
Research typically benefits the next generation.
"Being involved in a study like this with regular health reviews where you're very closely monitored improves people's health. Our aim is to recruit our first families in January 2021."
Health Is Priceless
Sophie Elvin, of Tighes Hill, is incredibly grateful for the help she's receiving from Professor Craig Pennell at John Hunter Hospital.
Ms Elvin is 36 weeks into her pregnancy. Her baby is due in early October.
"I'm ready to pop," she quipped.
She's part of a study into preterm labour.
"It's about how to prevent preterm births. I lost my little boy in September last year due to going into labour early," she said.
"You don't expect it. You get past your first trimester and you think you're safe and you'll become a mum. You start planning everything and getting the nursery set up."
Her son Teddy was born at 21 weeks.
"My waters broke too early. Unfortunately my little boy was just a bit too small to resuscitate and keep alive. That's why I'm under the care of Professor Pennell. I'm considered high risk and a complex pregnancy."
She was healthy and fit while pregnant with Teddy.
"What happened to me is kind of like cause unknown."
Ms Elvin isn't part of Professor Pennell's Newcastle 1000 study because it doesn't start until next year, but she said it sounded great because "health is priceless".
"I've been really lucky to be part of the team at John Hunter Hospital because they've been closely monitoring me throughout this pregnancy. They've been able to give me so many tips, support and guidance.
"Every week I'm checked up on, I have scans. I've had such precise, professional care to get as far as I have, which is somewhat of a miracle.
"It's amazing that this type of healthcare is available to me. I think we're so lucky to be in Australia with the healthcare system we have."
As for exercise, at her stage of pregnancy she is doing stretching and breathing.
"It's very similar to yoga. It's very gentle, nothing extreme."
She's had complications with her current pregnancy since the 23-week mark.
"I had to stop work, take bed rest and take it easy," said Ms Elvin, who has a property styling business and previously spent seven years driving dump trucks in the mines.
"Diet has been huge for me - upping my iron and protein."
She's also been eating sweet potatoes, nuts, yoghurt, green vegetables and eggs, which are "really good for a healthy placenta".