Non-communicable diseases such as obesity, diabetes, cardiovascular diseases, chronic respiratory diseases and mental health conditions are among the greatest health challenges of our time. However, modern medicine often intervenes only once risk factors or diseases are already present. An international group of researchers and practising clinicians is now advocating a broader approach: promoting long-term health should begin right at the start of life. 

This approach is at the heart of a study conducted under the scientific leadership of Martin Stocker, Head of Neonatology and Paediatric Intensive Care at the Central Switzerland Children's Hospital and Titular Professor of Medical Sciences at the University of Lucerne, and Thomas Pilgrim, Deputy Head of the University Clinic for Cardiology at Inselspital Bern and Professor at the University of Bern. Stefan Boes, Professor of Health Economics at the University of Lucerne, was also involved. The paper is based on an analysis of the existing scientific literature.

A window of opportunity that has so far been underutilised

The project team focuses on the period from conception to the first four weeks after birth. During this phase, key biological and psychosocial systems develop rapidly. The microbiome – the totality of microorganisms living in and on our bodies – and epigenetic regulation, which influences which genes are active in our cells, can, together with nutrition and early relational experiences, affect the subsequent development of non-communicable diseases.

The proposed approach goes beyond individual preventive measures. "We need to start thinking about health before illness even arises," says Stocker. "Measures relating to pregnancy, birth and the first weeks of life must, first and foremost, have an immediate positive effect. At the same time, we should take a more systematic approach to considering the significance these measures may have for long-term health."

This includes the targeted use of medicines, particularly antibiotics; avoiding medically unnecessary interventions; providing optimal nutrition, including promoting breastfeeding; and offering family-centred, developmentally supportive care.

A new research and health agenda

What is new here is not the recognition that early-life conditions can influence health later in life, but the attempt to bring these findings together in a coordinated approach to long-term health promotion. This approach encompasses biological, medical, nutritional and psychosocial factors, while taking into account both clinical and economic effects over the long term. Digital health data, new sensor technologies and artificial intelligence could, in future, help us to better understand long-term health and develop effective prevention strategies.

The authors argue that health benefits, the burden on the healthcare system and associated costs, as well as longer-term societal effects, should be considered together. This would provide a broader understanding of the value of early-life health promotion for individual children, families, the healthcare system and society as a whole.

Stocker Martin et al.
Promotion of long-term health in early life
Proceedings of the National Academy of Sciences (PNAS), 2026
Open Access article