The adolescent with respiratory disease.

Much adult lung disease, including asthma and chronic obstructive pulmonary disease (COPD), is likely to have its origin in fetal life and early childhood1, to be modified by genes2,3 and influenced by the establishment of lifestyles, including cigarette smoking, exercise and diet in the transition from childhood to adulthood (Fig 1). Most adult lifestyles are formed during childhood and adolescence, and therefore present targets for improving respiratory health in the adult population. These targets include improvement in dietary intake, particularly naturally occurring antioxidants, reduction in uptake of smoking and increase in physical exercise4. These factors are also important in the development of cardiovascular disease, obesity, and a range of diseases including hypertension and maturity-onset diabetes which are recognised to be largely preventable or modifiable. Advances in the medical management of childhood respiratory problems which previously had a high mortality are resulting in a gradual increase in the survival to young adulthood of individuals with problems such as chronic lung disease of prematurity and congenital diaphragmatic hernia, some of Peter Helms PhD FRCPE FRCPCH FRCP, Professor and Head of Department of Child Health, University of Aberdeen