Developmental Origins of Adult Health and Disease: The Role of Periconceptional and Foetal Nutrition

Abstract

The 'developmental origins of adult health and disease' hypothesis stated that environmental factors, particularly maternal undernutrition, act in early life to programme the risks for adverse health outcomes, such as cardiovascular disease, obesity and the metabolic syndrome in adult life. Early physiological tradeoffs, including activation of the foetal hypothalamo-pituitary-adrenal (HPA) axis, confer an early fitness advantage such as foetal survival, while incurring delayed health costs. We review the evidence that such tradeoffs are anticipated from conception and that the periconceptional nutritional environment can programme the developmental trajectory of the stress axis and the systems that maintain and regulate arterial blood pressure. There is also evidence that restriction of placental growth and function, results in an increased dependence of the maintenance of arterial blood pressure on the sequential recruitment of the sympathetic nervous system and HPA axis. While the 'early origins of adult disease' hypothesis has focussed on the impact of maternal undernutrition, an increase in maternal nutritional intake and in maternal body mass intake has become more prevalent in developed countries. Exposure to overnutrition in foetal life results in a series of central and peripheral neuroendocrine responses that in turn programme development of the fat cell and of the central appetite regulatory system. While the physiological responses to foetal undernutrition result in the physiological trade off between foetal survival and poor health outcomes that emerge after reproductive senescence, exposure to early overnutrition results in poor health outcomes that emerge in childhood and adolescence. Thus, the effects of early overnutrition can directly impact on reproductive fitness and on the health of the next generation. In this context, the physiological responses to relative overnutrition in early life may directly contribute to an intergenerational cycle of obesity.

Position of the Academy of Nutrition and Dietetics: Nutrition and Lifestyle for a Healthy Pregnancy Outcome

“…4 While physiological responses to prenatal overnutrition result in poor health outcomes that emerge in childhood and adolescence, fetal undernutrition responses range from fetal survival to poor health outcomes emerging later in the offspring's adult life. 14 The IOM recommends that more US women achieve gestational weight gain within the range identified for their prepregnant BMI. 4 Pregnant women benefit from eating a variety of foods to meet nutrient needs and consuming sufficient calories to support recommended weight gain.…”

“…Alcohol should not be consumed by pregnant women or those who may become pregnant. 14 Drinking alcohol during pregnancy, especially in early pregnancy, may result in behavioral or neurological defects in the offspring and affect a child's future intelligence. No safe level of alcohol consumption during pregnancy has been established.…”

“…Sugar-sweetened beverages, including regular sodas, sports drinks, energy drinks, and fruit drinks, provide 35.7% of added sugars in the US diet. 14 Reduced consumption of sources of added sugars lowers the calorie content of the diet without compromising nutrient adequacy.…”

“…14 The Dietary Guidelines for Americans forms the basis for nutrition counseling for postpartum women, and RDNs and dietetic technicians, registered can assist women in achieving their prepregnancy weight.…”

Effects of parity and periconceptional metabolic state of Holstein–Friesian dams on the glucose metabolism and conformation in their newborn calves

“…The Developmental Origins of Health and Disease (DoHAD) concept states that the nutritional state of mammals during the embryonic and foetal stages in utero has consequences for development and health in later life (McMillen et al, 2008). When exposed to unfavourable conditions, an embryo undergoes adaptations that enhance its chance of survival on the short term, but may become detrimental in postnatal life (Hales and Barker, 1992;Ravelli et al, 1998;Ozanne and Hales, 2002;Stocker et al, 2005).…”