Foetal Growth
- 3 stages and nutrition requirements
-The zygote: no increased requirements
- The early embryo: 6 week period, no increase in energy requirements, but nutrient intake v important, folate supps minimise neural tube defects in 17-30 days gestation period
- The foetal period: 7 months, energy & protein requirements increase
Nutritional Programming - Barker’s Hypothesis
- associations between low
birth weight and later disease risk including CHD, hypertension, metabolic
syndrome occurrence and type II diabetes
Dutch Famine
- babies
- first trimester
- mid-gestation
- Babies had higher risk of obesity,
increased circulating lipids, DMII risk
later in life if they were exposed to the
famine during the first trimester
Increased risk of impaired renal function
as adults when exposed to famine
during mid-gestation.
Siege of Leningrad
- babies
Babies Did NOT have higher risk of
obesity, CVD etc in later life
“The ______ _________ hypothesis proposes that the epidemiological
associations between poor foetal and infant growth and the
subsequent development of type 2 diabetes and the metabolic
syndrome result from the effects of ______ ________ in _____ ____, which
produces permanent changes in _______-______ metabolism.”
thrifty phenotype
poor nutrition
early life
glucose-insulin
THE THRIFTY PHENOTYPE
HYPOTHESIS
While in-utero “______” enables humans to receive a
“_______ _______” from their mothers, preparing them for the
world they will live in.
plasticity
weather forecast
WHY WOULD UNDERNUTRITION INCREASE
RISK OF DISEASE ASSOC WITH OBESITY?
- Fewer cells in organs
- Altered hormones & metabolism
- Increased vulnerability to adverse environmental influences in later life
Overnutrition risks for the mother
High blood pressure
Pre-eclampsia
Miscarriage & still-birth
Gestational diabetes
Caesarean sections
Difficultly losing weight after
birth
Overnutrition risks for the offspring
Congenital abnormalities
Small for gestational age
Foetal overgrowth
Preterm birth & neonatal
mortality
Childhood obesity
Adult obesity
DMII
Metabolic Syndrome
Overnutriton and Raised blood glucose
Even in non-diabetic, obese women have higher
blood glucose levels → foetal hyperinsulinemia, enhanced glycogenesis &
lipogenesis → ↑adipose tissue → ↓ insulin sensitivity
Overnutrition and altered feeding behaviours
- animal studies
Animal studies indicate maternal obesity is
linked with ↑ appetite in the off-spring
Overnutrition and increased fat intake
- rats
Offspring of rats fed high fat diets had increased
risk of dyslipidemia, hyperinsulinemia, insulin resistance and CVD and DM
II
The Boyd Orr study results
- Significantly lower overall mortality in
persons in the highest total dairy and
milk intake groups in childhood - Significantly lower risk of stroke
mortality and lower all‐cause
mortality in those who had the
highest childhood calcium intake
