Early Life Nutritional Programming of Adult Health Status

Abstract

There is increasing recognition that the risk of a broad range of non-communicable diseases, including obesity, cardiovascular disease and type 2 diabetes, are related not only to genetic predisposition but also to adaptive changes to environmental exposures during development. This concept, referred to as the Developmental Origins of Health and Disease (DOHaD) hypothesis, means that exposure to a sub-optimal environment during critical periods of development is associated with persistent changes to tissue morphology and function. This impairs the capacity of organ systems to adapt to physiological stressors, including ageing, in postnatal life and ultimately results in poor adult cardiometabolic health. The early DOHaD studies focussed primarily on the impacts of inadequate maternal nutrition and/or low birth weight and established the link between sub-optimal intrauterine growth and risk of poor adult cardiovascular and metabolic health. However, in contemporary Western societies, maternal over-nutrition, overweight and obesity are far more common nutritional issues and this has led to an increased focus of the field on the long-term consequences of exposure to these stimuli in early life. This Chapter will focus on exploring our current understanding of the impact of exposure to maternal overweight, obesity and poor quality Western-style diets on both the mother and her offspring. We will present evidence from both human epidemiological studies and animal models, and out forward practical suggestions for potential strategies to improve outcomes.