History of a Concept
In July 1982 I was invited to speak in Oxford at a conference organized by the McCarrison Society. My presentation, entitled 'Childbirth and the diseases of civilization', was a plea for a new kind of research to test the hypothesis that our health is to a great extent shaped at the very beginning of our life. We already had theoretical reasons to suppose that the sudden increased incidence of certain pathological conditions might be related to new powerful ways to interfere with the physiological processes in the perinatal period. At this conference I met Niko Tinbergen, one of the Nobel Prize winners in 1973 as a founder of ethology. He was the pioneer I was looking for since he had explored the risks for autism in relation to how the child was born. The correspondence we had afterwards encouraged me to prepare a book about the concept of health and what makes human beings more or less healthy.
This is how in 1986 I published the first edition of 'Primal Health'.1 Then we could predict that the spectacular advances in computer sciences would facilitate the new generation of research we were waiting for. It would become suddenly easier to explore correlations between what happens at the beginning of our life and what will happen later on in terms of health and personality traits.
I was convinced that we had to prepare for this new generation of research, first by adapting our vocabulary. I had to give a definition of 'the beginning of our life'. The period of human development when the basic adaptive systems – those involved in what we commonly call health – reach their maturity was called 'primal period': it includes fetal life, the perinatal period, and the year following birth. I also underlined the need for a simple term in order to get rid of the artificial and obsolete separations between the nervous system, the immune system and the endocrine system. I suggested the term 'primal adaptive system' when referring to this network: a way to avoid awkward terms such as 'psycho-neuro-immuno-endocrinologic system'. Health is how well our primal adaptive system works. 'Primal health' is the basic state of health in which we are at the end of the primal period; after that we can take advantage and cultivate this basic state of health. 'Primal health research' is this new framework of studies exploring correlations between what happens during the primal period and what will happen later on in life.
After the publication of 'Primal Health', the next step was to create in 1987 the 'Primal Health Research centre', based in London. Apart from occasional studies we can do by ourselves, our objective is to compile in the medical and scientific literature all studies that belong to the framework of primal health research. An explosion of such studies started in the late 1980s. First I was just collecting and classifying printed articles.
It is around 1990 that variants of the hypotheses included in "Primal Health" appeared in the mainstream medical literature. The "fetal origins of disease hypothesis" was inspired by the countless studies published by the "Barker group", a team of British epidemiologists based in Southampton. It became the "fetal/infant origins of disease hypothesis" in the mid-1990s2. There are obvious similarities between the "studies testing the fetal/infant origins of disease hypothesis" and "Primal Health Research". One of the main differences is that our key word is "health" instead of "disease". This gives an opportunity to stress that my first preoccupation has been to understand the genesis of a good health, while the "Barker hypothesis" leads to focus on the origins of a small number of specific illnesses, particularly metabolic and cardiovascular pathological conditions3. Improving our understanding of health may appear more fruitful than studying the origins of particular diseases.
In 1993 I was asked to prepare a second edition of 'Primal Health'. I thought it was impossible to update a book about such a fast evolving field of research. It was more relevant to launch a quarterly newsletter to provide updated information to a small core of supporters who had already understood the importance of this new generation of research. Thus the first issue of the 'Primal Health Research Newsletter' was published in summer 1993: the topic was: 'can drug addiction start at birth?' Since that time another issue of the newsletter has been published every three months. Each issue can be presented as an essay on one particular subject in relation to Primal Health Research. Our essays are reproduced in several journals in several languages. Some of these essays have been modified in order to be included in www.wombecology.com: the objective of this website is to convince anyone that prenatal ecology is the most vital aspect of human ecology, and that the period inside the womb is the life period with the highest adaptability and vulnerability to environmental factors.
In the late 1990s the spectacular advances in information technology and the fast development of primal health research led us to create a database available on the web. Today access to the Primal Health Research Database is free. We need this database because it is difficult to identify – among thousands of scientific and medical journals - studies that belong to this new framework: they are unrelated according to the current classifications. For example it would take a long time to find out that a pregnancy disease such as pre-eclampsia has been studied in relation to health conditions as diverse as prostate cancer, breast cancer, hypertension, asthma, allergic rhinitis, diabetes type 1, body size, age at menarche, behavior disorder, schizophrenia, mental retardation and cerebral palsy. After the Primal Health Research Database was established, I accepted to re-publish the book 'Primal Health' without any alteration of the original text. We just added an introduction to the second edition.2 This new edition was a useful document to evaluate the progress of primal health research within two decades. The original 1986 chapter 'Research in Primal Health' was followed by only 15 references!
One of the possible functions of our database is to train ourselves to think long-term. Human beings have not been programmed for long-term thinking. For millions of years our tropical ancestors consumed the food they could find from day to day in their environment, either by collecting shellfish and small fish in shallow water, by gathering plants and fruits, or by scavenging and hunting. After the comparatively recent advent of agriculture and animal breeding, they had to increase their capacity to anticipate. They were obliged to think at least in terms of seasons. Today we have at our disposal such powerful technologies that we must suddenly learn to think in terms of decades and centuries.
The sudden emergence in the scientific literature of the phrase 'gene expression' as a frequent keyword has suddenly assigned to our database an unexpected important new function.
Today the database contains hundreds of studies that have been published in authoritative medical and scientific journals. We offer a list of keywords and a list of authors in order to facilitate access to the relevant references and abstracts. In all fields of medicine and health sciences there are already studies that belong to the framework of primal health research. The advantage of our database is to offer an overview of hundreds of studies and to draw conclusions. Only such an overview can support our primary hypothesis that our health (including our capacity to love) is shaped during the primal period. Primal Health Research leads to a new understanding of the word 'health'.
Michel Odent
References:
- - Odent M. Primal Health. Century Hutchinson. London 1986 (paperback 1987).
- - Odent M. Primal Health. 2nd edition. Clairview Books. Forest Row (UK) 2002.
- - Gluckman PD, Hanson MA, Cooper C, Thornburg KL. Effect of In Utero and Early-Life Conditions on Adult Health and Disease. NEJM 2008; 359: 61-73