Relationship of fetal malnutrition and long term outcomes

Speaker: Prof. C. Fall Presented at: 74th Nestlé Nutrition Institute Workshop, Goa

Summary

Professor Caroline Fall shows how nutrition during pregnancy has effects not only on foetal development but also throughout an individual’s life. Initial suggestions of long-term effects came from historical records: adults born to mothers who lived through famine conditions (such as the Dutch Hunger Winter of 1944/1945) showed differences in obesity profiles compared to people born to mothers pregnant in non-famine times. In general, a low birth weight (LBW) was associated with adult-onset obesity and diabetes (T2DM), as well as higher risk of cardiovascular disease (CVD). The highest risk of developing T2DM or CVD was seen in LBW babies who became obese as adults. This pattern is consistent throughout the developed and developing world and is supported by animal models of foetal nutrition.

In contrast, high birth-weight babies are more likely to develop cancers, hypertension and have high BMIs. Likewise, children of diabetic mothers have a higher risk of developing T2DM themselves. Paternal and maternal nutrition play equal roles in influencing long-term outcomes. Professor Fall discusses the “Foetal Programming Hypothesis”, which addresses how transient, subtle exposures to malnutrition at critical developmental time points can influence foetal epigenesis with varied outcomes, and which can be inheritable. A summary of available evidence in humans for whether protein and micronutrient supplementation can improve long-term outcomes is presented.