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WAO Medical Book Reviews

August 2015

Origins: early-life solutions to the modern health crisis
By Susan L. Prescott, BMedSc, MB BS, PhD
Copyright 2015 UWA Publishing (University of Western Australia)
ISBN: 9781742586700 (Print)

List Price: $21.99 USD / $29.99 AUD / $33.50 NZD
Available from: UWA Publishing

Reviewer
Phillip L. Lieberman, MD
Asthma & Allergy Associates
Germantown, Tennessee, USA

About three years ago I had the great pleasure of reviewing Dr. Susan Prescott's wonderful book "The Allergy Epidemic: A Mystery of Modern Life." In that text, she sought for the "why" behind our modern day allergy epidemic. Dr. Prescott is a pediatrician-allergist-immunologist, and that endeavor which she carried out in peerless fashion, seemed natural for to her to pursue as it related intimately to her chosen specialty. In her newest book, "Origins: Early-life Solutions to the Modern Health Crisis", she wears the same hat but breaks new ground by further applying the same scientific approach to uncover the "why" behind the modern day epidemic of other non-communicable diseases. She explores the "why" underlying a wide range of conditions including obesity; diabetes; abnormalities of behavior and neural functioning; maladies of bone, muscle, and joints; cancer; and aging. Her quest is to find the roots of the origins of these diseases in the relationship between early life (starting with the fetus) and our "modern day" environment. At first blush a seemingly quixotic venture. But in characteristic fashion she pulls it off flawlessly, emerging with a gem. Also included in this quest is a chapter revisiting the "why" of asthma, allergy, and other immune diseases. This chapter, which recapitulates and expands her first volume, "The Allergy Epidemic", is alone worth the price of this intriguing work.

Dr. Prescott's thesis is that "adverse conditions during critical stages of our development can have a profound effect on our body structures, functions, and our developing behaviors. In many cases, the consequences may not appear until much later in life, through effects on our biological reserve, and our capacity to deal with life's challenges." Thus channeling William Wordsworth, reiterating with science his touch of wisdom, "The child is the father of the man" [1].

She supports this thesis with an elegant example of translating complicated epidemiologic and laboratory science into clear, succinct, and enjoyable prose. This is her gift. She is the rare physician-scientist, who has the insight and skills of a professional science writer. But what is truly unique about her accomplishments in this particular text is the breadth of her knowledge and the scope of the endeavor. Susan Prescott is a pediatrician, and yet she exhibits in this text an immense and detailed knowledge of the early life origins of conditions, as mentioned above, which are normally the purview of the internist/gerontologist. And what is equally impressive is the fact that she incorporates in a clear and concise fashion the basic science to support her thesis. Her topics and vocabulary range from telomeres and methylation of DNA to leptin, ghrelin and insulin-like growth factor-1. She is equally comfortable with neonatal health and osteoporosis of the elderly.

Although the target audience of this book appears to be the lay public, it is written with the discipline of a medical text, employing as many as 122 references per chapter. These references have been culled from a wide variety of peer reviewed journals from multiple disciplines. The depth of understanding is also at a level which would expand the knowledge base and scientific horizon of all but the most erudite physicians. So this is not only a good read for our patients, but also an enlightening text for their physicians. It is particularly of interest to the allergist-immunologist who incorporates control of the environment in our practice and has great interest in the effect of the environment on the diseases that we treat.

The enjoyment of the text is enhanced by Dr. Prescott's personal anecdotes and philosophical touches. These well-spaced additions give a pleasurable respite from the concepts explored which challenge our thoughts and imagination as we read.

It is a nice and proper size (278 pages of narrative) which to me was a "three-nighter". I didn't want to see it end.


Footnote:

1. "My Heart Leaps Up When I Behold", William Wordsworth, 1802