The First Thousand Days: Epigenetics in the Age of Global Health

  • Michelle Pentecost


The 1000 days between conception and a child’s second birthday is considered to be a crucial period for determining future health and potential, an understanding shaped by knowledge in the fields of the developmental origins of health and disease (DOHaD), neuroscience and epigenetics. Using a South African case study of the global ‘first thousand days’ initiative, in this chapter I examine how DOHaD and epigenetic knowledge, as ‘biosocial’ objects of enquiry, are embedded in global discourses that come to bear on the every day.



The Commonwealth Scholarship Commission in the UK has generously funded my doctoral research. Stanley Ulijaszek and the Unit for Biocultural Variation and Obesity at the University of Oxford and Fiona Ross and the First Thousand Days research group at the University of Cape Town have provided two complementary intellectual homes for this work. I extend heartfelt thanks to Stanley Ulijaszek, Tess Bird, Thomas Cousins and the anonymous reviewer for their reading and constructive criticism of earlier drafts. Small portions of this text appeared in Somatosphere—The First Thousand Days of Life Series, Introduction. The author gratefully acknowledges the permission from the editor to reuse these sections.


  1. Adams, Vincanne, Nancy J. Burke, and Ian Whitmarsh. 2014. Slow Research: Thoughts for a Movement in Global Health. Medical Anthropology 33 (3, Jan.): 179–197.CrossRefGoogle Scholar
  2. Adams, Vincanne, Michelle Murphy, and Adele E. Clarke. 2009. Anticipation: Technoscience, Life, Affect, Temporality. Subjectivity 28: 246–265.CrossRefGoogle Scholar
  3. Anderson, Warwick. 2014. Making Global Health History: The Postcolonial Worldliness of Biomedicine. Social History of Medicine 27 (2): 372–384.CrossRefGoogle Scholar
  4. Baird, Barbara. 2008. Child Politics, Feminist Analysis. Australian Feminist Studies 23: 291–305.CrossRefGoogle Scholar
  5. Barker, David J., and Clive Osmond. 1986. Infant Mortality, Childhood Nutrition, and Ischaemic Heart Disease in England and Wales. Lancet 1 (8489): 1077–1081.CrossRefGoogle Scholar
  6. Bayart, Jean-Francois. 1993. The State in Africa: The Politics of the Belly. London: Longman.Google Scholar
  7. Biehl, João Guilherme. 2011. When People Come First: Beyond Technical and Theoretical Quick-Fixes in Global Health. In Global Political Ecology, ed. Richard Peet, Paul Robbins, and Michael Watts, 100–130. New York: Routledge.Google Scholar
  8. Biehl, João Guilherme. 2013. Ethnography in the Way of Theory. Cultural Anthropology 28 (4): 573–597.CrossRefGoogle Scholar
  9. Biehl, João Guilherme, and Adriana Petryna, eds. 2013. When People Come First: Critical Studies in Global Health. Princeton: Princeton University Press.Google Scholar
  10. Black, Robert E., Cesar G. Victora, Susan P. Walker, Zulfiqar A. Bhutta, Parul Christian, Mercedes de Onis, Majid Ezzati, et al. 2013. Maternal and Child Undernutrition and Overweight in Low-Income and Middle-Income Countries. Lancet 6736 (13): 427–451.CrossRefGoogle Scholar
  11. Brada, Betsey. 2011. ‘Not Here’: Making the Spaces and Subjects of ‘Global Health’ in Botswana. Culture, Medicine and Psychiatry 35 (2): 285–312.CrossRefGoogle Scholar
  12. Brown, Tim, and Morag Bell. 2008. Imperial or Postcolonial Governance? Dissecting the Genealogy of a Global Public Health Strategy. Social Science & Medicine 67 (10): 1571–1579.CrossRefGoogle Scholar
  13. Bryce, Jennifer, Denise Coitinho, Ian Darnton-Hill, David Pelletier, and Per Pinstrup-Andersen. 2008. Maternal and Child Undernutrition: Effective Action at National Level. Lancet 371 (9611): 510–526.CrossRefGoogle Scholar
  14. Burman, Erica. 1994. Innocents Abroad: Western Fantasies of Childhood and the Iconography of Emergencies. Disasters 18 (3): 238–253.CrossRefGoogle Scholar
  15. Caduff, Carlo. 2014. Pandemic Prophecy, or How to Have Faith in Reason. Current Anthropology 55 (3): 296–315.CrossRefGoogle Scholar
  16. Canguilhem, Georges. 1978. On the Normal and the Pathological. Boston: D Reidel.CrossRefGoogle Scholar
  17. Carney, Megan A. 2015. Eating and Feeding at the Margins of the State: Barriers to Health Care for Undocumented Migrant Women and the ‘Clinical’ Aspects of Food Assistance. Medical Anthropology Quarterly 29 (2): 196–215.CrossRefGoogle Scholar
  18. Carolina, Martı́nez S., and Leal F. Gustavo. 2003. Epidemiological Transition: Model or Illusion? A Look at the Problem of Health in Mexico. Social Science & Medicine 57 (3): 539–550.Google Scholar
  19. Castañeda, Claudia. 2002. Figurations. Durham: Duke University Press.CrossRefGoogle Scholar
  20. Chatterji, Roma, Sangeeta Chattoo, and Veena Das. 1998. The Death of the Clinic? Normality and Pathology in Recrafting Aging Bodies. In Vital Signs: Feminist Reconfigurations of the Bio/Logical Body, ed. Margrit Shildrick and Janet Price, 171–196. Edinburgh: Edinburgh University Press.Google Scholar
  21. Chen, Lincoln C., Arthur Kleinman, and Norma C. Ware, eds. 1993. Health and Social Change in International Perspective. Boston: Harvard University Press.Google Scholar
  22. Crane, Johanna Tayloe. 2013. Scrambling for Africa: AIDS, Expertise, and the Rise of American Global Health Science. Ithaca: Cornell University Press.Google Scholar
  23. Das, Veena, and Ranendra K. Das. 2006. Pharmaceuticals in Urban Ecologies: The Register of the Local. In Global Pharmaceuticals: Ethics, Markets, Practices, ed. Adriana Petryna, Andrew Lakoff, and Arthur Kleinman, 171–205. Durham: Duke University Press.Google Scholar
  24. Department of Health: Republic of South Africa. 2013. Roadmap for Nutrition in South Africa 2013–2017. Pretoria: Department of Health.Google Scholar
  25. El-Haj, Nadia Abu. 2007. The Genetic Reinscription of Race. Annual Review of Anthropology 36: 283–300.CrossRefGoogle Scholar
  26. Escobar, Arturo. 1995. Encountering Development: The Making and Unmaking of the Third World. Princeton: Princeton University Press.Google Scholar
  27. Fassin, Didier. 2012a. Humanitarian Reason: A Moral History of the Present. Berkeley: University of California Press.Google Scholar
  28. ———. 2012b. That Obscure Object of Global Health. In Medical Anthropology at the Intersections: Histories, Activisms, Futures, ed. Marcia Inhorn and Emily A. Wentzell, 95–115. Durham: Duke University Press.Google Scholar
  29. ———. 2013. Children as Victims—The Moral Economy of Childhood in the Times of AIDS. In When People Come First: Critical Studies in Global Health, ed. João Guilherme Biehl and Adriana Petryna, 109–129. Princeton: Princeton University Press.Google Scholar
  30. Foucault, Michel. 2002(1972). The Archaeology of Knowledge. Oxford: Routledge.Google Scholar
  31. Frenk, Julio, Jose L. Bobadilla, Jaime Sepulveda, and Malaquias Lopez. 1989. Health Transition in Middle-Income Countries: New Challenges for Health Care. Health Policy and Planning 4 (1): 29–39.CrossRefGoogle Scholar
  32. Ginsburg, Faye, and Rayna Rapp. 1991. The Politics of Reproduction. Annual Review of Anthropology 20: 311–343.CrossRefGoogle Scholar
  33. Gluckman, Peter D., and Mark A. Hanson. 2012. Fat, Fate, and Disease: Why Exercise and Diet are Not Enough. New York: Oxford University Press.Google Scholar
  34. Goodfellow, Aaron. 2014. Pedagogies of the Clinic: Learning to Live (Again and Again). In Wording the World: Veena Das and Scenes of Instruction, ed. Roma Chatterji, 38–54. New York: Fordham University Press.CrossRefGoogle Scholar
  35. Groenwald, P., W. Msemburi, E. Morden, N. Zinyakatira, I. Neethling, J. Daniels, J. Evans, et al. 2014. Western Cape Mortality Profile 2011. Cape Town: South African Medical Research Council.Google Scholar
  36. Guthman, Julie, and Becky Mansfield. 2013. The Implications of Environmental Epigenetics: A New Direction for Geographic Inquiry on Health, Space, and Nature-Society Relations. Progress in Human Geography 37 (4): 486–504.CrossRefGoogle Scholar
  37. Guyer, Jane I. 2007. Prophecy and the near Future: Thoughts on Macroeconomic, Evangelical, and Punctuated Time. American Ethnologist 3: 409–421.CrossRefGoogle Scholar
  38. Hales, C. Nicholas, and David J.P. Barker. 1992. Type 2 (Non-Insulin-Dependent) Diabetes Mellitus: The Thrifty Phenotype Hypothesis. Diabetologia 35: 595–601.CrossRefGoogle Scholar
  39. Horton, Richard. 2014. Offline: A New Path towards Anticipatory Global Health. The Lancet 384 (9950): 1248.CrossRefGoogle Scholar
  40. Hunt, Nancy Rose. 1999. A Colonial Lexicon: Of Birth Ritual, Medicalization, and Mobility in the Congo. London: Duke University Press.CrossRefGoogle Scholar
  41. Kermack, W.O., A.G. McKendrick, and P.L. Mckinlay. 1934. Death Rates in Great Britain and Sweden. Some General Regularities and Their Significance. Lancet 223 (5770): 698–703.CrossRefGoogle Scholar
  42. King, Nicholas B. 2002. Security, Disease, Commerce: Ideologies of Postcolonial Global Health. Social Studies of Science 32 (5): 763–789.CrossRefGoogle Scholar
  43. Kuh, Diana, and George Davey Smith. 1993. When Is Mortality Risk Determined? Historical Insights into a Current Debate. Social History of Medicine 6 (1): 101–123.CrossRefGoogle Scholar
  44. Lakoff, Andrew, and Stephen J. Collier. 2008. Biosecurity Interventions: Global Health & Security in Question. New York: Columbia University Press.CrossRefGoogle Scholar
  45. Landecker, Hannah. 2011. Food as Exposure: Nutritional Epigenetics and the New Metabolism. BioSocieties 6 (2): 167–194.CrossRefGoogle Scholar
  46. ———. 2016. The Social as Signal in the Body of Chromatin. The Sociological Review Monographs 64 (1): 79–99.CrossRefGoogle Scholar
  47. Lock, Margaret. 2005. Eclipse of the Gene and the Return of Divination. Current Anthropology 46 (S5): S47–S70.CrossRefGoogle Scholar
  48. Lock, Margaret, and Vinh-Kim Nguyen. 2010. An Anthropology of Biomedicine. Oxford: Wiley-Blackwell.Google Scholar
  49. Maher, Jane Maree, Suzanne Fraser, and Jan Wright. 2010. Framing the Mother: Childhood Obesity, Maternal Responsibility and Care. Journal of Gender Studies 19 (3): 233–247.CrossRefGoogle Scholar
  50. Malkki, Liisa. 2015. The Need to Help: The Domestic Arts of International Humanitarianism. Durham: Duke University Press.CrossRefGoogle Scholar
  51. Mansfield, Becky. 2012. Race and the New Epigenetic Biopolitics of Environmental Health. BioSocieties 7 (1): 352–272.CrossRefGoogle Scholar
  52. Mansfield, Becky, and Julie Guthman. 2015. Epigenetic Life: Biological Plasticity, Abnormality, and New Configurations of Race and Reproduction. Cultural Geographies 22 (1): 3–20.CrossRefGoogle Scholar
  53. McNaughton, Darlene. 2011. From the Womb to the Tomb: Obesity and Maternal Responsibility. Critical Public Health 21 (2): 179–190.CrossRefGoogle Scholar
  54. Meloni, Maurizio. 2016. Political Biology : Science and Social Values in Human Heredity from Eugenics to Epigenetics. Basingstoke: Palgrave Macmillan.Google Scholar
  55. Meloni, Maurizio, and Giuseppe Testa. 2014. Scrutinizing the Epigenetics Revolution. BioSocieties 9 (4): 1–26.CrossRefGoogle Scholar
  56. Merry, Sally Engle. 2011. Measuring the World. Current Anthropology 52 (S3): S83–S95.CrossRefGoogle Scholar
  57. Mudimbé, Valentin-Yves. 1988. The Invention of Africa: Gnosis, Philosophy, and the Order of Knowledge. London: Currey.Google Scholar
  58. Müller-Wille, Staffan, and Hans-Jörg Rheinberger. 2012. A Cultural History of Heredity. Chicago: University of Chicago Press.CrossRefGoogle Scholar
  59. Nading, Alex M. 2015. Chimeric Globalism. American Ethnologist 42 (2): 356–370.CrossRefGoogle Scholar
  60. Nguyen, Vinh-Kim. 2010. The Republic of Therapy: Triage and Sovereignty in West Africa’s Time of AIDS. Durham: Duke University Press.CrossRefGoogle Scholar
  61. Nichter, Mark. 2008. Global Health: Why Cultural Perceptions, Social Representations, and Biopolitics Matter. Tucson: University of Arizona Press.Google Scholar
  62. Nichter, Mark, and Carl Kendall. 1991. Beyond Child Survival: Anthropology and International Health in the 1990s. Medical Anthropology Quarterly 5 (3): 195–203.CrossRefGoogle Scholar
  63. Osmani, Siddiq, and Amartya Sen. 2003. The Hidden Penalties of Gender Inequality: Fetal Origins of Ill-Health. Economics and Human Biology 1: 105–121.CrossRefGoogle Scholar
  64. Petryna, Adriana. 2009. When Experiments Travel: Clinical Trials and the Global Search for Human Subjects. Princeton: Princeton University Press.CrossRefGoogle Scholar
  65. Pickersgill, Martyn, Jörg Niewöhner, Ruth Müller, Paul Martin, and Sarah Cunningham-Burley. 2013. Mapping the New Molecular Landscape: Social Dimensions of Epigenetics. New Genetics and Society 32 (4): 429–447.CrossRefGoogle Scholar
  66. Pigg, Stacy Leigh. 2013. On Sitting and Doing: Ethnography as Action in Global Health. Social Science & Medicine 99: 127–134.CrossRefGoogle Scholar
  67. Popkin, Barry M. 1993. Nutritional Patterns and Transitions. Population and Development Review 19 (1): 138–157.CrossRefGoogle Scholar
  68. Popkin, Barry M., Linda S. Adair, and Shu Wen Ng. 2011. Global Nutrition Transition and the Pandemic of Obesity in Developing Countries. Nutrition Reviews 70 (1): 3–21.CrossRefGoogle Scholar
  69. Quarles van Ufford, Phillip, and Ananta Kumar Giri. 2003. A Moral Critique of Development: In Search of Global Responsibilities. London: Routledge.Google Scholar
  70. Richardson, Sarah S. 2015. Maternal Bodies in the Postgenomic Order: Gender and the Explanatory Landscape of Epigenetics. In Postgenomics: Perspectives on Biology and the Genome, ed. Sarah S. Richardson and Hallam Stevens, 210–231. Durham: Duke University Press.CrossRefGoogle Scholar
  71. Richardson, Sarah S., and Hallam Stevens, eds. 2015. Postgenomics: Perspectives on Biology and the Genome. Durham: Duke University Press.Google Scholar
  72. Saracci, Richard. 2007. Epidemiological Concepts Pre-1950 and Their Relation to Work in the Second Half of the Century. In The Development of Modern Epidemiology: Personal Reports from Those Who Were There, ed. Walter W. Holland, Jørn Olsen, and Charles du V. Florey, 31–38. Oxford: Oxford University Press.CrossRefGoogle Scholar
  73. Shisana, Olive, Demetre Labadarios, Thomas Rehle, Leickness Simbayi, Khangelani Zuma, Ali Dhansay, Priscilla Reddy, et al. 2013. South African National Health and Nutrition Examination Survey (SANHANES-1). Cape Town: HSRC Press.Google Scholar
  74. Shostak, Sara, and Margot Moinester. 2015. The Missing Piece of the Puzzle? Measuring the Environment in the Postgenomic Moment. In Postgenomics: Perspectives on Biology and the Genome, ed. Sarah S. Richardson and Hallam Stevens, 192–209. Durham: Duke University Press.CrossRefGoogle Scholar
  75. Sridhar, Devi. 2008. The Role of Structure and Agency in Hunger Reduction in India. Indian Journal of Gender Studies 15 (1): 81–99.CrossRefGoogle Scholar
  76. Steyn, Krisela, Jean Fourie, and Norman Temple, eds. 2006. Chronic Diseases of Lifestyle 1995–2005. Technical Report. Cape Town: Medical Research Council.Google Scholar
  77. Sunder Rajan, Kaushik, ed. 2012. Lively Capital: Biotechnologies, Ethics, and Governance in Global Markets. Durham: Duke University Press.Google Scholar
  78. Taussig, Karen Sue, Klaus Hoeyer, and Stefan Helmreich. 2013. The Anthropology of Potentiality in Biomedicine. Current Anthropology 54 (S7): S3–S14.CrossRefGoogle Scholar
  79. Taylor-Alexander, Samuel. 2015. Adjacent Temporalities: Making Medico-Scientific Futures and the Present. Engaging Science, Technology and Society 1: 67–72.CrossRefGoogle Scholar
  80. Thacker, Eugene. 2005. The Global Genome: Biotechnology, Politics, and Culture. Cambridge, MA: MIT Press.Google Scholar
  81. Ulijaszek, Stanley J., Sarah Elton, and Neil Mann. 2012. Evolving Human Nutrition: Implications for Public Health. Cambridge: Cambridge University Press.CrossRefGoogle Scholar
  82. Vaughan, Meghan. 1991. Curing Their Ills: Colonial Power and African Illness. Stanford: Stanford University Press.Google Scholar
  83. Victora, Cesar G., Linda Adair, Caroline Fall, Pedro C. Hallal, Reynaldo Martorell, Linda Richter, and Harshpal Singh Sachdev. 2008. Maternal and Child Undernutrition: Consequences for Adult Health and Human Capital. Lancet 371 (9609): 340–357.CrossRefGoogle Scholar
  84. Von Schnitzler, Antina. 2013. Traveling Technologies: Infrastructure, Ethical Regimes, and the Materiality of Politics in South Africa. Cultural Anthropology 28 (4): 670–693.CrossRefGoogle Scholar
  85. Vorster, Hester H., Lesley T. Bourne, Christina S. Venter, and Welma Oosthuizen. 1999. Contribution of Nutrition to the Health Transition in Developing Countries: A Framework for Research and Intervention. Nutrition Reviews 57 (11): 341–349.CrossRefGoogle Scholar
  86. Waddington, Conrad. 1942. The Epigenotype. Endeavour 1: 18–20.Google Scholar
  87. Warin, Megan, Tanya Zivkovic, Vivienne Moore, and Michael Davies. 2012. Mothers as Smoking Guns: Fetal Overnutrition and the Reproduction of Obesity. Feminism & Psychology 22 (3): 360–375.CrossRefGoogle Scholar
  88. Waterland, Robert A., and Karin B. Michels. 2007. Epigenetic Epidemiology of the Developmental Origins Hypothesis. Annual Review of Nutrition 27: 363–388.CrossRefGoogle Scholar
  89. Wheeler, Erica. 1985. To Feed or to Educate: Labelling in Targeted Nutrition Interventions. In Labelling in Development Policy, ed. Geoff Wood, 475–483. London: SAGE.Google Scholar
  90. Yates-Doerr, Emily. 2011. Bodily Betrayal: Love and Anger in the Time of Epigenetics. In A Companion to the Anthropology of the Body and Embodiment, ed. Frances E. Mascia-Lees, 292–306. Chichester: Wiley-Blackwell.CrossRefGoogle Scholar
  91. ———. 2015. The Weight of Obesity: Hunger and Global Health in Postwar Guatemala. Berkeley: University of California Press.CrossRefGoogle Scholar
  92. Zarowsky, Christina, Slim Haddad, and Vinh-Kim Nguyen. 2013. Beyond ‘Vulnerable Groups’: Contexts and Dynamics of Vulnerability. Global Health Promotion 20 (S1l): 3–9.CrossRefGoogle Scholar
  93. Zivkovic, Tanya, Megan Warin, Michael Davies, and Vivienne Moore. 2010. In the Name of the Child: The Gendered Politics of Childhood Obesity. Journal of Sociology 46 (4): 375–392.CrossRefGoogle Scholar

Copyright information

© The Author(s) 2018

Authors and Affiliations

  • Michelle Pentecost
    • 1
  1. 1.University of OxfordOxfordUK

Personalised recommendations