In the framework of the XIX Latin American Congress of Paediatrics held in September 2022 in Punta Cana, the Asociación Latinoamericana de Pediatría (ALAPE, Latin American Pediatric Association) presented the Declaration for the Prevention of Noncommunicable Diseases (NCDs), to be endorsed by its affiliates—the Asociación Española de Pediatría (AEP, Spanish Association of Paediatrics) among them—with the commitment of implementing the strategies proposed in its statements.1

Noncommunicable diseases are the leading cause of death worldwide, generate substantial public health expenditures and pose a significant challenge to the development of individuals and communities. Cardiovascular disease (CVD), diabetes, high blood pressure (HBP), cancer, immune disorders and behavioural disorders are the most relevant among them.2

Based on data from the Panamerican Health Organization (PAHO) and the World Health Organization (WHO), NCDs are responsible for 71% of annual deaths globally and are the leading cause of premature death in individuals aged less than 70 years.3

The main risk factor for these diseases is obesity, which is currently increasing worldwide with a prevalence of overweight and obesity of approximately 33.6% of the paediatric population aged 5–19 years.

Robust scientific evidence from the past decades shows that the susceptibility to have an NCD at some point in the lifespan depends on adverse environmental factors that are at play from the early stages of development, even before conception and in the first 1000 days post birth.4

Exposure to these factors modifies foetal programming, inducing epigenetic adaptative responses that lead to anatomical and functional abnormalities and to the expression of phenotypes associated with an increased susceptibility to the development of NCDs. These changes can affect subsequent generations through epigenetic transgenerational inheritance.

This knowledge is the foundation of the Developmental Origins of Health and Disease (DOHaD) concept.5

In its declaration, the ALAPE highlighted the importance of adequate and sensitive care, the promotion of breastfeeding, a timely and perceptive introduction of appropriate foods, the promotion of safe environments, free of violence and environmental toxins, and the need for adequate training of health care providers and education of the community, among other strategies aimed at promoting a healthy environment and reducing the burden of NCDs.

We are convinced that the implementation of these strategies through interdisciplinary and intersectoral actions sustained through time will contribute to the improvement of health and the reduction of the burden of NCDs. This would also be in conformity with the Sustainable Health Agenda for the Americas 2030 (ASSA 2030) and the Sustainable Development Goals (SDGs).

Since the paediatrician is the primary care physician of the child and adolescent and the provider counselling families, it is in a privileged position to offer appropriate guidance contributing to reduce the risk of the patient developing an NCD at some point in life, which also paves the way for improved health in future generations.