Submitted:
28 August 2025
Posted:
29 August 2025
Read the latest preprint version here
Abstract
Keywords:
1. Introduction
2. Material and Methods
2.1. Global Trend Lines Determination
2.2. Statistical Analysis
3. Results
3.1. Evidence of Population-Based Epigenetic Degeneration in Human Populations
3.1.1. Examples of Epigenetic Degeneration in Human Populations: Somatic Diseases
3.1.2. Examples of Epigenetic Degeneration: Mental Health Issues
3.2. The Comorbidities Snowball and the Ladder Effect
3.2.1. The Comorbidities Snowball
3.2.2. The Ladder Effect
4. Discussion
4.1. Different Explanations, One Common Root
4.2. The Common Root’s Uncomfortable Implication
4.3. The Comorbidities Snowball Nature of Multimorbidity
4.4. The Principle of Pre-Determined Post-Processing
4.4.1. Multimorbidity: The Signature of Inheritance
4.4.2. Beyond the Principle of Labelled Lines
4.5. Evolutionary Consideration
4.6. Epidemiological Considerations
4.7. Social Considerations
Supplementary Materials
Author Contributions
References
- Marsellach, X. Ageing is not just ageing. Zenodo. 2025. [Google Scholar]
- Marsellach, X. The Principle of Continuous Biological Information Flow as the Fundamental Foundation for the Biological Sciences. Implications for Ageing Research. Preprints. 2021. [Google Scholar]
- Marsellach, X. A non-Lamarckian model for the inheritance of the epigenetically-coded phenotypic characteristics: a new paradigm for Genetics, Genomics and, above all, Ageing studies. bioRxiv. 2018. [Google Scholar]
- Marsellach, X. A non-genetic meiotic repair program inferred from spore survival values in fission yeast wild isolates: a clue for an epigenetic ratchet-like model of ageing. bioRxiv. 2017. [Google Scholar]
- Korolenko, A.; Skinner, M.K. Generational stability of epigenetic transgenerational inheritance facilitates adaptation and evolution. Epigenetics 2024, 19, 2380929. [Google Scholar] [CrossRef]
- Witzany G, editor. Epigenetics in Biological Communication. Cham: Springer Nature Switzerland; 2024:0.
- Karin, O.; Miska, E.A.; Simons, B.D. Epigenetic inheritance of gene silencing is maintained by a self-tuning mechanism based on resource competition. Cell Systems 2023, 14, 24–40. [Google Scholar] [CrossRef] [PubMed]
- Takahashi, Y.; Morales Valencia, M.; Yu, Y.; et al. Transgenerational inheritance of acquired epigenetic signatures at CpG islands in mice. Cell 2023, 186, 715–731. [Google Scholar] [CrossRef]
- Jablonka, E.; Lamb, M.J. Inheritance Systems and the Extended Evolutionary Synthesis. Cambridge: Cambridge University Press. 2020. [Google Scholar]
- Jablonka, E.; Lamb, M.J. Evolution in four dimensions, revised edition: Genetic, epigenetic, behavioral, and symbolic variation in the history of life. 2014. [Google Scholar]
- Gissis, S.; Gissis, S.B.; Jablonka, E.; Zeligowski, A. Transformations of Lamarckism: from subtle fluids to molecular biology. 2011. [Google Scholar]
- Jablonka, E.; Lamb, M.J. Epigenetic inheritance and evolution: the Lamarckian dimension. 1995. [Google Scholar]
- Spadafora, C. Transgenerational epigenetic reprogramming of early embryos: a mechanistic model. Environ Epigenet 2020, 6, dvaa009. [Google Scholar] [CrossRef] [PubMed]
- Skinner, M.K. Environmental Epigenetics and a Unified Theory of the Molecular Aspects of Evolution: A Neo-Lamarckian Concept that Facilitates Neo-Darwinian Evolution. Genome Biol Evol 2015, 7, 1296–1302. [Google Scholar] [CrossRef]
- Surachman, A.; Hamlat, E.; Zannas, A.S.; Horvath, S.; Laraia, B.; Epel, E. Grandparents’ educational attainment is associated with grandchildren’s epigenetic-based age acceleration in the National Growth and Health Study. Soc Sci Med 2024, 355, 117142. [Google Scholar] [CrossRef]
- Watson, E.D. Epigenetics of transgenerational inheritance of disease. Epigenetics in Human Disease. Elsevier; 2024. p. 989-1030.
- Švorcová, J. Transgenerational Epigenetic Inheritance of Traumatic Experience in Mammals. Genes (Basel) 2023, 14, 120. [Google Scholar] [CrossRef]
- Deshe, N.; Eliezer, Y.; Hoch, L.; et al. Inheritance of associative memories and acquired cellular changes in C. elegans. Nat Commun 2023, 14, 4232. [Google Scholar] [CrossRef] [PubMed]
- Sabarís, G.; Fitz-James, M.H.; Cavalli, G. Epigenetic inheritance in adaptive evolution. Ann N Y Acad Sci 2023, 1524, 22–29. [Google Scholar] [CrossRef]
- Liberman, N.; Rothi, M.H.; Gerashchenko, MV.; et al. 18S rRNA methyltransferases DIMT1 and BUD23 drive intergenerational hormesis. Mol Cell 2023, 83, 3268–3282. [Google Scholar] [CrossRef]
- Schmitz, L.L.; Duque, V. In utero exposure to the Great Depression is reflected in late-life epigenetic aging signatures. Proc Natl Acad Sci U S A 2022, 119, e2208530119. [Google Scholar] [CrossRef]
- Lempradl, A. Germ cell-mediated mechanisms of epigenetic inheritance. Semin Cell Dev Biol 2020, 97, 116–122. [Google Scholar] [CrossRef]
- Norouzitallab, P.; Baruah, K.; Vanrompay, D.; Bossier, P. Can epigenetics translate environmental cues into phenotypes. Sci Total Environ 2019, 647, 1281–1293. [Google Scholar] [CrossRef] [PubMed]
- Wang, Y.; Liu, H.; Sun, Z. Lamarck rises from his grave: parental environment-induced epigenetic inheritance in model organisms and humans. Biol Rev Camb Philos Soc 2017, 92, 2084–2111. [Google Scholar] [CrossRef] [PubMed]
- Marsellach, X. The Double Code Hypothesis of Ageing. Preprints. 2025. [Google Scholar]
- Ledford, H. Why are so many young people getting cancer? What the data say. Nature 2024, 627, 258–260. [Google Scholar]
- Licari, A.; Magri, P.; De Silvestri, A.; et al. Epidemiology of Allergic Rhinitis in Children: A Systematic Review and Meta-Analysis. J Allergy Clin Immunol Pract 2023, 11, 2547–2556. [Google Scholar] [CrossRef]
- van Straalen, J.W.; de Roock, S.; Giancane, G.e.t. al. Prevalence of familial autoimmune diseases in juvenile idiopathic arthritis: results from the international Pharmachild registry. Pediatr Rheumatol Online J 2022, 20, 103. [Google Scholar] [CrossRef]
- Moscheo, C.; Licciardello, M.; Samperi, P.; La Spina, M.; Di Cataldo, A.; Russo, G. New Insights into Iron Deficiency Anemia in Children: A Practical Review. Metabolites 2022, 12, 289. [Google Scholar] [CrossRef]
- Lo, M.S. Lupus in children. Systemic Lupus Erythematosus. Elsevier; 2021. p. 527-533.
- Sahin, Y. Celiac disease in children: A review of the literature. World J Clin Pediatr 2021, 10, 53–71. [Google Scholar] [CrossRef]
- Wong, K.; Dahlmann-Noor, A. Myopia and its progression in children in London, UK: a retrospective evaluation. J Optom 2020, 13, 146–154. [Google Scholar] [CrossRef]
- Langan, S.M.; Irvine, A.D.; Weidinger, S. Atopic dermatitis. Lancet 2020, 396, 345–360. [Google Scholar] [CrossRef]
- Song, P.; Zhang, Y.; Yu, J.; et al. Global Prevalence of Hypertension in Children: A Systematic Review and Meta-analysis. JAMA Pediatr 2019, 173, 1154–1163. [Google Scholar] [CrossRef]
- Lascar, N.; Brown, J.; Pattison, H.; Barnett, A.H.; Bailey, C.J.; Bellary, S. Type 2 diabetes in adolescents and young adults. The lancet Diabetes & endocrinology 2018, 6, 69–80. [Google Scholar]
- Caldwell, C.C.; Saikaly, S.K.; Dellavalle, R.P.; Solomon, J.A. Prevalence of pediatric alopecia areata among 572,617 dermatology patients. Journal of the American Academy of Dermatology 2017, 77, 980–981. [Google Scholar] [CrossRef]
- Ackerman, I.N.; Kemp, J.L.; Crossley, K.M.; Culvenor, A.G.; Hinman, R.S. Hip and Knee Osteoarthritis Affects Younger People, Too. J Orthop Sports Phys Ther 2017, 47, 67–79. [Google Scholar] [CrossRef]
- Sahoo, K.; Sahoo, B.; Choudhury, A.K.; Sofi, N.Y.; Kumar, R.; Bhadoria, A.S. Childhood obesity: causes and consequences. J Family Med Prim Care 2015, 4, 187–192. [Google Scholar]
- Asher, I.; Pearce, N. Global burden of asthma among children. Int J Tuberc Lung Dis 2014, 18, 1269–1278. [Google Scholar] [CrossRef]
- Patterson CC, Dahlquist GG, Gyürüs E, Green A, Soltész G, EURODIAB Study Group. Incidence trends for childhood type 1 diabetes in Europe during 1989-2003 and predicted new cases 2005-20: a multicentre prospective registration study. Lancet 2009, 373, 2027–2033. [CrossRef]
- Branum, A.M.; Lukacs, S.L. Food allergy among children in the United States. Pediatrics 2009, 124, 1549–1555. [Google Scholar] [CrossRef]
- GBD 2021 Diseases and Injuries Collaborators. Global incidence, prevalence, years lived with disability (YLDs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries in 204 countries and territories and 811 subnational locations, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021. Lancet 2024, 403, 2133–2161.
- Hambleton, I.R.; Caixeta, R.; Jeyaseelan, S.M.; Luciani, S.; Hennis, A.J.M. The rising burden of non-communicable diseases in the Americas and the impact of population aging: a secondary analysis of available data. Lancet Reg Health Am 2023, 21, 100483. [Google Scholar] [CrossRef]
- Charalampous, P.; Gorasso, V.; Plass, D.; et al. Burden of non-communicable disease studies in Europe: a systematic review of data sources and methodological choices. Eur J Public Health 2022, 32, 289–296. [Google Scholar] [CrossRef]
- Noncommunicable Diseases: A Globalization of Disparity? [editorial]. PLoS Med 2015, 12, e1001859.
- Michalek, I.M.; Koczkodaj, P.; Michalek, M.; Caetano Dos Santos, F.L. Unveiling the silent crisis: global burden of suicide-related deaths among children aged 10-14 years. World J Pediatr. 2024. [CrossRef]
- Gupta, T.; Gehlawat, P. Assessment and Management of Emerging Personality Disorders in Adolescents. 2023. p. 255-267.
- Sun, C.F.; Xie, H.; Metsutnan, V.; et al. The mean age of gender dysphoria diagnosis is decreasing. Gen Psychiatr 2023, 36, e100972. [Google Scholar] [CrossRef]
- Shaw, K.A.; McArthur, D.; Hughes, MM.; et al. Progress and disparities in early identification of autism spectrum disorder: autism and developmental disabilities monitoring network, 2002-2016. Journal of the American Academy of Child & Adolescent Psychiatry 2022, 61, 905–914. [Google Scholar]
- Steinsbekk, S.; Ranum, B.; Wichstrøm, L. Prevalence and course of anxiety disorders and symptoms from preschool to adolescence: a 6-wave community study. Journal of Child Psychology and Psychiatry 2022, 63, 527–534. [Google Scholar] [CrossRef]
- Hendriks, S.; Peetoom, K.; Bakker, C.; et al. Global incidence of young-onset dementia: A systematic review and meta-analysis. Alzheimers Dement. 2022. [Google Scholar] [CrossRef]
- Tkacz, J.; Brady, B.L. Increasing rate of diagnosed childhood mental illness in the United States: Incidence, prevalence and costs. Public Health Pract (Oxf) 2021, 2, 100204. [Google Scholar] [CrossRef]
- Singh, M.K.; Post, R.M.; Miklowitz, DJ.; et al. A commentary on youth onset bipolar disorder. Bipolar Disord 2021, 23, 834–837. [Google Scholar] [CrossRef]
- Twenge, J.M.; Cooper, A.B.; Joiner, T.E.; Duffy, M.E.; Binau, S.G. Age, period, and cohort trends in mood disorder indicators and suicide-related outcomes in a nationally representative dataset, 2005-2017. J Abnorm Psychol 2019, 128, 185–199. [Google Scholar] [CrossRef]
- Hollis, C. Schizophrenia in children and adolescents. BJPsych Advances 2015, 21, 333–341. [Google Scholar] [CrossRef]
- Nicholls, D.E.; Lynn, R.; Viner, R.M. Childhood eating disorders: British national surveillance study. Br J Psychiatry 2011, 198, 295–301. [Google Scholar] [CrossRef]
- Multimorbidity: Addressing the next global pandemic [editorial]. PLoS Med 2023, 20, e1004229.
- Chowdhury, S.R.; Chandra Das, D.; Sunna, T.C.; Beyene, J.; Hossain, A. Global and regional prevalence of multimorbidity in the adult population in community settings: a systematic review and meta-analysis. EClinicalMedicine 2023, 57, 101860. [Google Scholar] [CrossRef]
- Rising to the challenge of multimorbidity [editorial]. BMJ 2020;368:l6964.
- Carlson, D.M.; Yarns, B.C. Managing medical and psychiatric multimorbidity in older patients. Ther Adv Psychopharmacol 2023, 13, 20451253231195274. [Google Scholar] [CrossRef]
- Wędrychowicz, A.; Minasyan, M.; Pietraszek, A.; et al. Increased prevalence of celiac disease and its clinical picture among patients with diabetes mellitus type 1—observations from a single pediatric center in Central Europe. Pediatr Endocrinol Diabetes Metab 2021, 27, 1–6. [Google Scholar] [CrossRef] [PubMed]
- Boulet, L.P. Obesity and atopy. Clin Exp Allergy 2015, 45, 75–86. [Google Scholar] [CrossRef] [PubMed]
- Cristofori, F.; Fontana, C.; Magistà, A.; et al. Increased prevalence of celiac disease among pediatric patients with irritable bowel syndrome: a 6-year prospective cohort study. JAMA Pediatr 2014, 168, 555–560. [Google Scholar] [CrossRef] [PubMed]
- Lee, N.R.; Kim, B.K.; Yoon, N.Y.; Lee, S.Y.; Ahn, S.Y.; Lee, W.S. Differences in Comorbidity Profiles between Early-Onset and Late-Onset Alopecia Areata Patients: A Retrospective Study of 871 Korean Patients. Ann Dermatol 2014, 26, 722–726. [Google Scholar] [CrossRef]
- Friedlander, J.L.; Sheehan, W.J.; Baxi, S.N.; et al. Food Allergy and Increased Asthma Morbidity in a School-Based Inner-City Asthma Study. The Journal of Allergy and Clinical Immunology: In Practice 2013, 1, 479–484. [Google Scholar] [CrossRef]
- Kramer, R.; Aarnio-Peterson, C.M.; Conard, L.A.; Lenz, K.R.; Matthews, A. Eating disorder symptoms among transgender and gender diverse youth. Clin Child Psychol Psychiatry 2024, 29, 30–44. [Google Scholar] [CrossRef]
- Chidambaram, S.; Theni, M.C.; Kaliappan, K.; et al. The Prevalence of Depressive Symptoms in Schizophrenia: A Cross-Sectional Study. Path of Science 2023, 9, 4001–4006. [Google Scholar] [CrossRef]
- Rahnejat, A.M.; Babaie, M.; Ebrahimi, M.; et al. The prevalence of cluster B personality disorder in young male homosexuals. 2022. [Google Scholar]
- Hisle-Gorman, E.; Landis, C.A.; Susi, A.; et al. Gender Dysphoria in Children with Autism Spectrum Disorder. LGBT Health 2019, 6, 95–100. [Google Scholar] [CrossRef]
- George, R.; Stokes, M.A. Sexual Orientation in Autism Spectrum Disorder. Autism Research 2018, 11, 133–141. [Google Scholar] [CrossRef]
- Matsuo, J.; Kamio, Y.; Takahashi, H.; et al. Autistic-like traits in adult patients with mood disorders and schizophrenia. PLoS One 2015, 10, e0122711. [Google Scholar] [CrossRef]
- Connor, D.F.; Doerfler, L.A. ADHD with comorbid oppositional defiant disorder or conduct disorder: discrete or nondistinct disruptive behavior disorders. J Atten Disord 2008, 12, 126–134. [Google Scholar] [CrossRef]
- McIntyre, R.S.; Soczynska, J.K.; Bottas, A.; Bordbar, K.; Konarski, J.Z.; Kennedy, S.H. Anxiety disorders and bipolar disorder: a review. Bipolar Disorders 2006, 8, 665–676. [Google Scholar] [CrossRef]
- Mayer, A.R.; Kosson, D.S. Handedness and Psychopathy. Cognitive and Behavioral Neurology. 2000. [Google Scholar]
- Wade, T.D.; Bulik, C.M.; Neale, M.; Kendler, K.S. Anorexia nervosa and major depression: shared genetic and environmental risk factors. Am J Psychiatry 2000, 157, 469–471. [Google Scholar] [CrossRef]
- Bailey, J.M. Homosexuality and mental illness. Archives of general psychiatry 1999, 56, 883–884. [Google Scholar] [CrossRef] [PubMed]
- Satz, P.; Green, M.F. Atypical handedness in schizophrenia: some methodological and theoretical issues. Schizophr Bull 1999, 25, 63–78. [Google Scholar] [CrossRef]
- Langs, G.; Quehenberger, F.; Fabisch, K.; Klug, G.; Fabisch, H.; Zapotoczky, H.G. Prevalence, patterns and role of personality disorders in panic disorder patients with and without comorbid (lifetime) major depression. Acta Psychiatrica Scandinavica 1998, 98, 116–123. [Google Scholar] [CrossRef]
- Adesuyan, M.; Jani, Y.H.; Alsugeir, D.; et al. Trends in the incidence of dementia in people with hypertension in the UK 2000 to 2021. Alzheimers Dement (Amst) 2023, 15, e12466. [Google Scholar] [CrossRef] [PubMed]
- Ciciulla, D.; Soriano, V.X.; McWilliam, V.; Koplin, J.J.; Peters, R.L. Systematic Review of the Incidence and/or Prevalence of Eating Disorders in Individuals With Food Allergies. J Allergy Clin Immunol Pract 2023, 11, 2196–2207. [Google Scholar] [CrossRef] [PubMed]
- Launders, N.; Kirsh, L.; Osborn, D.P.J.; Hayes, J.F. The temporal relationship between severe mental illness diagnosis and chronic physical comorbidity: a UK primary care cohort study of disease burden over 10 years. Lancet Psychiatry 2022, 9, 725–735. [Google Scholar] [CrossRef]
- Annamalai, A.; Kosir, U.; Tek, C. Prevalence of obesity and diabetes in patients with schizophrenia. World J Diabetes 2017, 8, 390–396. [Google Scholar] [CrossRef] [PubMed]
- Lopez-de-Andrés, A.; Jiménez-Trujillo, M.I.; Hernández-Barrera, V.; et al. Trends in the prevalence of depression in hospitalized patients with type 2 diabetes in Spain: analysis of hospital discharge data from 2001 to 2011. PLoS One 2015, 10, e0117346. [Google Scholar] [CrossRef] [PubMed]
- Raevuori, A.; Haukka, J.; Vaarala, O.; et al. The increased risk for autoimmune diseases in patients with eating disorders. PLoS One 2014, 9, e104845. [Google Scholar] [CrossRef]
- Ceretta, L.B.; Réus, G.Z.; Abelaira, HM.; et al. Increased prevalence of mood disorders and suicidal ideation in type 2 diabetic patients. Acta Diabetol. 2012, 49 Suppl 1, S227–34. [Google Scholar] [CrossRef]
- Darby, A.; Hay, P.; Mond, J.; Quirk, F.; Buttner, P.; Kennedy, L. The rising prevalence of comorbid obesity and eating disorder behaviors from 1995 to 2005. Int J Eat Disord 2009, 42, 104–108. [Google Scholar] [CrossRef]
- Janson, J.; Laedtke, T.; Parisi, J.E.; O’Brien, P.; Petersen, R.C.; Butler, P.C. Increased risk of type 2 diabetes in Alzheimer disease. Diabetes 2004, 53, 474–481. [Google Scholar] [CrossRef]
- Anderson, R.J.; Freedland, K.E.; Clouse, R.E.; Lustman, P.J. The prevalence of comorbid depression in adults with diabetes: a meta-analysis. Diabetes Care 2001, 24, 1069–1078. [Google Scholar] [CrossRef]
- Morris, D.L.; Montgomery, S.M.; Galloway, M.L.; Pounder, R.E.; Wakefield, A.J. Inflammatory bowel disease and laterality: is left handedness a risk. Gut 2001, 49, 199–202. [Google Scholar] [CrossRef]
- Wu, L.; He, Y.; Jiang, B.; et al. Trends in prevalence, awareness, treatment and control of hypertension during 2001-2010 in an urban elderly population of China. PloS one 2015, 10, e0132814. [Google Scholar] [CrossRef]
- Ten Have, M.; Verheul, R.; Kaasenbrood, A.; et al. Prevalence rates of borderline personality disorder symptoms: a study based on the Netherlands Mental Health Survey and Incidence Study-2. BMC Psychiatry 2016, 16, 249. [Google Scholar] [CrossRef] [PubMed]
- Haller, H.; Cramer, H.; Lauche, R.; Gass, F.; Dobos, G.J. The prevalence and burden of subthreshold generalized anxiety disorder: a systematic review. BMC Psychiatry 2014, 14, 128. [Google Scholar] [CrossRef]
- Isomaa, R.; Isomaa, A.L.; Marttunen, M.; Kaltiala-Heino, R.; Björkqvist, K. The prevalence, incidence and development of eating disorders in Finnish adolescents: a two-step 3-year follow-up study. Eur Eat Disord Rev 2009, 17, 199–207. [Google Scholar] [CrossRef] [PubMed]
- Swanson, S.A.; Crow, S.J.; Le Grange, D.; Swendsen, J.; Merikangas, K.R. Prevalence and correlates of eating disorders in adolescents. Results from the national comorbidity survey replication adolescent supplement. Arch Gen Psychiatry 2011, 68, 714–723. [Google Scholar] [CrossRef] [PubMed]
- Organization, W.H. Haemoglobin concentrations for the diagnosis of anaemia and assessment of severity. 2011. [Google Scholar]
- American Diabetes Association. 2. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes-2020. Diabetes Care 2020, 43, S14–S31. [CrossRef] [PubMed]
- Fernandes, S. Prediction of a rise in antisocial personality disorder through cross-generational analysis. Prediction of an Increase in Personality Disorder. 2019.
- Coid, J.; Ullrich, S. Antisocial personality disorder is on a continuum with psychopathy. Compr Psychiatry 2010, 51, 426–433. [Google Scholar] [CrossRef]
- Twells, L.K.; Janssen, I.; Kuk, J.L. Epidemiology of Adult Obesity. Edmonton, Canada: Obesity Canada; 2020.
- Devlin, H. More than 800 million people around the world have diabetes, study finds. 2024. [Google Scholar]
- Stobbe, M. CDC finds nearly 1 in 3 US youth have prediabetes, but experts question scant data. 2024. [Google Scholar]
- Marsh, S. Half a billion young people will be obese or overweight by 2030, report finds. 2025. [Google Scholar]
- McManus, S. One in four young people in England have mental health condition, NHS survey finds. 2025. [Google Scholar]
- Stobbe, M. American kids have become increasingly unhealthy over nearly two decades, new study finds. 2024. [Google Scholar]
- Simmons-Duffin, S. Autism rates keep rising. What RFK Jr. and the CDC plan to do next. 2025. [Google Scholar]
- Mason, J. Trump administration cut autism-related research by 26% so far in 2025. 2025. [Google Scholar]
- Editorial, B. What’s going on at HHS? RFK Jr.’s staffing choices raise alarm. 2025. [Google Scholar]
- Rocque, R.J.; Beaudoin, C.; Ndjaboue, R.; et al. Health effects of climate change: an overview of systematic reviews. BMJ Open 2021, 11, e046333. [Google Scholar] [CrossRef]
- Strachan, D.P. Hay fever, hygiene, and household size. BMJ 1989, 299, 1259–1260. [Google Scholar] [CrossRef]
- Bach, J.-F. The effect of infections on susceptibility to autoimmune and allergic diseases. N Engl J Med 2002, 347, 911–920. [Google Scholar] [CrossRef]
- Elwood, P.; Galante, J.; Pickering, J.; et al. Healthy lifestyles reduce the incidence of chronic diseases and dementia: evidence from the Caerphilly cohort study. PLoS One 2013, 8, e81877. [Google Scholar] [CrossRef]
- Gut Microbiota Dysbiosis: Triggers, Consequences, Diagnostic and Therapeutic Options [editorial]. Microorganisms 2022;10(3):578.
- Portela, A.; Esteller, M. Epigenetic modifications and human disease. Nat Biotechnol 2010, 28, 1057–1068. [Google Scholar] [CrossRef] [PubMed]
- Griffiths, P.E.; Bourrat, P. Integrating evolutionary, developmental and physiological mismatch. Evol Med Public Health 2023, 11, 277–286. [Google Scholar] [CrossRef]
- Anway, M.D.; Cupp, A.S.; Uzumcu, M.; Skinner, M.K. Epigenetic transgenerational actions of endocrine disruptors and male fertility. Science 2005, 308, 1466–1469. [Google Scholar] [CrossRef]
- Ben Maamar, M.; Wang, Y.; Nilsson, E.E.; Beck, D.; Yan, W.; Skinner, M.K. Transgenerational sperm DMRs escape DNA methylation erasure during embryonic development and epigenetic inheritance. Environ Epigenet 2023, 9, dvad003. [Google Scholar] [CrossRef]
- Hill, P.W.S.; Leitch, H.G.; Requena, CE.; et al. Epigenetic reprogramming enables the transition from primordial germ cell to gonocyte. Nature 2018, 555, 392–396. [Google Scholar] [CrossRef]
- Hackett, J.A.; Surani, M.A. DNA methylation dynamics during the mammalian life cycle. Philos Trans R Soc Lond B Biol Sci 2013, 368, 20110328. [Google Scholar] [CrossRef]
- Cowley, M.; Oakey, R.J. Resetting for the next generation. Mol Cell 2012, 48, 819–821. [Google Scholar] [CrossRef]
- Kobayashi, H.; Sakurai, T.; Imai, M.; et al. Contribution of intragenic DNA methylation in mouse gametic DNA methylomes to establish oocyte-specific heritable marks. PLoS Genet 2012, 8, e1002440. [Google Scholar] [CrossRef]
- Smith, Z.D.; Chan, M.M.; Mikkelsen, TS.; et al. A unique regulatory phase of DNA methylation in the early mammalian embryo. Nature 2012, 484, 339–344. [Google Scholar] [CrossRef] [PubMed]
- Hirasawa, R.; Chiba, H.; Kaneda, M.; et al. Maternal and zygotic Dnmt1 are necessary and sufficient for the maintenance of DNA methylation imprints during preimplantation development. Genes Dev 2008, 22, 1607–1616. [Google Scholar] [CrossRef] [PubMed]
- Li, E. Chromatin modification and epigenetic reprogramming in mammalian development. Nat Rev Genet 2002, 3, 662–673. [Google Scholar] [CrossRef]
- Gluckman, P.D.; Hanson, M.A. Living with the past: evolution, development, and patterns of disease. Science 2004, 305, 1733–1736. [Google Scholar] [CrossRef]
- Heijmans, B.T.; Tobi, E.W.; Stein, AD.; et al. Persistent epigenetic differences associated with prenatal exposure to famine in humans. Proc Natl Acad Sci U S A 2008, 105, 17046–17049. [Google Scholar] [CrossRef]
- Yehuda, R.; Daskalakis, N.P.; Lehrner, A.; et al. Influences of maternal and paternal PTSD on epigenetic regulation of the glucocorticoid receptor gene in Holocaust survivor offspring. American Journal of Psychiatry 2014, 171, 872–880. [Google Scholar] [CrossRef]
- Accordini, S.; Calciano, L.; Johannessen, A.; et al. A three-generation study on the association of tobacco smoking with asthma. Int J Epidemiol 2018, 47, 1106–1117. [Google Scholar] [CrossRef] [PubMed]
- Tonegawa, S. Somatic generation of antibody diversity. Nature 1983, 302, 575–581. [Google Scholar] [CrossRef]
- Matarese, G. The link between obesity and autoimmunity. Science 2023, 379, 1298–1300. [Google Scholar] [CrossRef] [PubMed]
- Lin, H.-J.; Wei, C.-C. Chang C-Y.; et al. Role of Chronic Inflammation in Myopia Progression: Clinical Evidence and Experimental Validation. EBioMedicine 2016, 10, 269–281. [Google Scholar] [CrossRef]
- Moulin, D.; Sellam, J.; Berenbaum, F.; Guicheux, J.; Boutet, M.-A. The role of the immune system in osteoarthritis: mechanisms, challenges and future directions. Nature Reviews Rheumatology 2025, 21, 221–236. [Google Scholar] [CrossRef] [PubMed]
- Cheng, W.; Du, Z.; Lu, B. Chronic low-grade inflammation associated with higher risk and earlier onset of cardiometabolic multimorbidity in middle-aged and older adults: a population-based cohort study. Sci Rep 2024, 14, 22635. [Google Scholar] [CrossRef]
- Ioakeim-Skoufa, I.; González-Rubio, F.; Aza-Pascual-Salcedo, M.; et al. Multimorbidity patterns and trajectories in young and middle-aged adults: a large-scale population-based cohort study. Front Public Health 2024, 12, 1349723. [Google Scholar] [CrossRef]
- Furman, D.; Campisi, J.; Verdin, E.; et al. Chronic inflammation in the etiology of disease across the life span. Nature Medicine 2019, 25, 1822–1832. [Google Scholar] [CrossRef] [PubMed]
- Cordova, R.; Viallon, V.; Fontvieille, E.; et al. Consumption of ultra-processed foods and risk of multimorbidity of cancer and cardiometabolic diseases:multinational cohort study. The Lancet Regional Health—Europe. 2023. [Google Scholar]
- Ward-Caviness, C.K.; Moyer, J.; Weaver, A.; Devlin, R.; Diaz-Sanchez, D. Associations between PFAS occurrence and multimorbidity as observed in an electronic health record cohort. Environ Epidemiol 2022, 6, e217. [Google Scholar] [CrossRef] [PubMed]
- Mendoza, K.; Smith-Warner, S.A.; Rossato, SL.; et al. Ultra-processed foods and cardiovascular disease: analysis of three large US prospective cohorts and a systematic review and meta-analysis of prospective cohort studies. Lancet Reg Health Am 2024, 37, 100859. [Google Scholar] [CrossRef]
- Beier, M.A.; Setoguchi, S.; Gerhard, T.; et al. Early childhood antibiotics and chronic pediatric conditions: a retrospective cohort study. J Infect Dis. 2025. [CrossRef] [PubMed]
- Hoskinson, C.; Petersen, C.; Turvey, S.E. How the early life microbiome shapes immune programming in childhood asthma and allergies. Mucosal Immunol 2025, 18, 26–35. [Google Scholar] [CrossRef]
- Huang, W.; Zhang, Z.; Colucci, M.; et al. The mixed effect of Endocrine-Disrupting chemicals on biological age Acceleration: Unveiling the mechanism and potential intervention target. Environ Int 2024, 184, 108447. [Google Scholar] [CrossRef]
- Symeonides, C.; Aromataris, E.; Mulders, Y.; et al. An Umbrella Review of Meta-Analyses Evaluating Associations between Human Health and Exposure to Major Classes of Plastic-Associated Chemicals. Ann Glob Health 2024, 90, 52. [Google Scholar] [CrossRef]
- Nnadi, N.E.; Carter, D.A. Climate change and the emergence of fungal pathogens. PLoS Pathog 2021, 17, e1009503. [Google Scholar] [CrossRef]
- Sánchez-Valle, J.; Valencia, A. Molecular bases of comorbidities: present and future perspectives. Trends Genet 2023, 39, 773–786. [Google Scholar] [CrossRef]
- Reyes-Diaz, S.A.; Priego-Parra, B.A.; Ordaz-Alvarez, HR.; et al. Unequal Burdens: Irritable Bowel Syndrome in Sexual and Gender Minority Communities vs Cisgender Heterosexual Individuals. Clin Transl Gastroenterol. 2025. [Google Scholar] [CrossRef]
- Stein, T.; Collins, S.; St Louis, J. The prevalence of hypermobile Ehlers-Danlos syndrome at a gender-affirming primary care clinic. SAGE Open Med 2025, 13, 20503121251315021. [Google Scholar] [CrossRef]
- Tabor, E.; Kneale, D.; Patalay, P. Sexuality and respiratory outcomes in the UK: disparities, development and mediators in multiple longitudinal studies. Public Health 2025, 247, 105886. [Google Scholar] [CrossRef] [PubMed]
- Deraz, O.; Caceres, B.; Streed, CG.; et al. Sexual Minority Status Disparities in Life’s Essential 8 and Life’s Simple 7 Cardiovascular Health Scores: A French Nationwide Population-Based Study. J Am Heart Assoc 2023, 12, e028429. [Google Scholar] [CrossRef] [PubMed]
- Wegener, D.; McFaline-Figueroa, J.; Goldstein, R. Migraine Prevalence in Gender Identity Minorities (P14-12. 004). Neurology 2023, 100, 4340. [Google Scholar] [CrossRef]
- Simon, A.B.; Norland, K.; Blackburn, M.; Zhao, S.; Wang, X.; Harris, R.A. Evidence of increased cardiovascular disease risk in left-handed individuals. Front Cardiovasc Med 2023, 10, 1326686. [Google Scholar] [CrossRef]
- Kallitsounaki, A.; Williams, D.M. Autism Spectrum Disorder and Gender Dysphoria/Incongruence. A systematic Literature Review and Meta-Analysis. J Autism Dev Disord 2023, 53, 3103–3117. [Google Scholar] [PubMed]
- Goetz, T.G.; Adams, N. The transgender and gender diverse and attention deficit hyperactivity disorder nexus: A systematic review. Journal of Gay & Lesbian Mental Health. 20221-18.
- Sherman, J.; Dyar, C.; McDaniel, J.; et al. Sexual minorities are at elevated risk of cardiovascular disease from a younger age than heterosexuals. J Behav Med 2022, 45, 571–579. [Google Scholar] [CrossRef] [PubMed]
- Maggio, M.G.; Calatozzo, P.; Cerasa, A.; Pioggia, G.; Quartarone, A.; Calabrò, R.S. Sex and Sexuality in Autism Spectrum Disorders: A Scoping Review on a Neglected but Fundamental Issue. Brain Sci 2022, 12, 1427. [Google Scholar] [CrossRef]
- Nastou, E.; Ocklenburg, S.; Hoogman, M.; Papadatou-Pastou, M. Handedness in ADHD: Meta-Analyses. Neuropsychol Rev 2022, 32, 877–892. [Google Scholar] [CrossRef]
- Warrier, V.; Greenberg, D.M.; Weir, E.; et al. Elevated rates of autism, other neurodevelopmental and psychiatric diagnoses, and autistic traits in transgender and gender-diverse individuals. Nat Commun 2020, 11, 3959. [Google Scholar] [CrossRef] [PubMed]
- Nagata, J.M.; Ganson, K.T.; Tabler, J.; Blashill, A.J.; Murray, S.B. Disparities Across Sexual Orientation in Migraine Among US Adults. JAMA Neurol 2020, 78, 117–118. [Google Scholar] [CrossRef] [PubMed]
- Stewart, C.C.; Swanson, S.J.; Sabsevitz, D.S.; Rozman, M.E.; Janecek, J.K.; Binder, J.R. Predictors of language lateralization in temporal lobe epilepsy. Neuropsychologia 2014, 60, 93–102. [Google Scholar] [CrossRef]
- Morfit, N.S.; Weekes, N.Y. Handedness and immune function. Brain and Cognition 2001, 46, 209–213. [Google Scholar] [CrossRef]
- Geschwind, N.; Behan, P. Left-handedness: association with immune disease, migraine, and developmental learning disorder. Proceedings of the National Academy of Sciences 1982, 79, 5097–5100. [Google Scholar] [CrossRef]
- Blanchard, R. Birth order and sibling sex ratio in homosexual versus heterosexual males and females. Annu Rev Sex Res 1997, 8, 27–67. [Google Scholar] [CrossRef] [PubMed]
- Blanchard, R.; Bogaert, A.F. Homosexuality in men and number of older brothers. Am J Psychiatry 1996, 153, 27–31. [Google Scholar]
- Ganna, A.; Verweij, K.J.H.; Nivard, MG.; et al. Large-scale GWAS reveals insights into the genetic architecture of same-sex sexual behavior. Science. 2019. [Google Scholar]
- Wang, Y.; Wang, J. Modelling and prediction of global non-communicable diseases. BMC Public Health 2020, 20, 822. [Google Scholar] [CrossRef]
- Hartl, D.L.; Clark, A.G. Principles of Population Genetics. Sunderland, MA: Sinauer Associates. 2007. [Google Scholar]
- Mayr, E. Change of genetic environment and evolution Evolution as a Process. In: 1st, Huxley J, Hardy AC, Ford EBLondon: Allen & Unwin; 1954. p. 157-180.
- Goldman, M. RFK Jr.’s vaccine pullback stokes fears of lost medical breakthroughs. 2025. [Google Scholar]




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