DOHaD (Developmental Origins): The lifelong imprint of early nutrition

In this episode of Milestones in Pediatric Nutrition, Professor Andrew Prentice interviews Professor Chittaranjan Yajnik about the Developmental Origins of Health and Disease (DOHaD) theory. Professor Yajnik traces the evolution from David Barker's initial "Fetal Origins of Adult Disease" hypothesis, which demonstrated geographic correlations between early-life deprivation and adult cardiovascular disease mortality across English counties. The theory has evolved beyond hypothesis status, supported by extensive cohort studies, animal models, and mechanistic research demonstrating how intrauterine and early-life conditions influence later risk of non-communicable diseases. Professor Yajnik discusses his collaboration with Barker beginning in 1991 and explains why India provided an ideal research setting given its high prevalence of low birth weight and rapidly increasing diabetes rates. His groundbreaking research revealed the "Yajnik-Yudkin (YY) paradox," demonstrating that Indians develop diabetes at younger ages with lower BMI but higher body fat percentages compared to Europeans. The "thin-fat Indian baby syndrome" further showed that Indian newborns, despite being 800 grams lighter, exhibit proportionally higher adiposity and metabolic risk markers at birth, establishing critical evidence for DOHaD's relevance in South Asian populations and informing early-life intervention strategies.