Beyond the Barker hypothesis and the thrifty genotype - The womb, ethnicity, genes and the environment - Recent perspectives on the evolution of diabetes and the metabolic syndrome in India

Abstract

The increasing prevalence of diabetes mellitus in the country can be explained in part by the large changes in lifestyle that have occurred over the years over the last couple of decades. A number of studies have shown that these changes have been demonstrated predominantly in Dravidian and Aryan ethnic groups of the country. Some of these studies have not taken into account the proper definition of a rural environment. The other factors which may be responsible for the rising prevalence of diabetes and the metabolic syndrome in rural India are the impact of low birth weight and the influence of a hostile intrauterine environment (the thrifty phenotype hypothesis) and the impact of the genetic factors that may interact and influence the evolution of this condition. There was room therefore to study the body composition, physiological variables including energy expenditure, insulin resistance, micro-quanta of fat and genetic variables in these individuals.