The early life nutritional environment and early life stress as potential pathways towards the metabolic syndrome in mid-life? A lifecourse analysis using the 1958 British Birth cohort.

C Delpierre,M Darnaudéry,R Fantin,C Barboza-Solis,M Kelly-Irving,B Lepage

doi:10.1186/s12889-016-3484-0

Abstract

BackgroundLifecourse studies suggest that the metabolic syndrome (MetS) may be rooted in the early life environment. This study aims to examine the pathways linking early nutritional and psychosocial exposures and the presence of MetS in midlife.MethodsData are from the National Child Development Study including individuals born during 1 week in 1958 in Great Britain and followed-up until now. MetS was defined based on the National Cholesterol Education Program Adult Treatment Panel III classification. Mother’s pre-pregnancy body mass index (BMI) was used as a proxy of the early nutritional environment and Adverse Childhood Experiences (ACE) as a proxy for early psychosocial stress. Socioeconomic characteristics, pregnancy and birth conditions were extracted as potential confounders. Adult health behaviors, BMI, socioeconomic environment and psychological state were considered as mediating variables.Multivariate models were performed by including variables sequentially taking a lifecourse approach.Results37.5 % of men and 19.8 % of women had MetS. Participants with an obese/overweight mother presented a higher risk of MetS than those whose mother had a normal pre-pregnancy BMI. Men exposed to two ACE or more, and women exposed to one ACE, were more at risk of MetS compared to unexposed individuals. After including confounders and mediators, mother’s pre-pregnancy BMI was still associated with MetS in midlife but the association was weakened after including participant’s adult BMI. ACE was no longer associated with MetS after including confounders in models.ConclusionsThe early nutritional environment, represented by mother’s pre-pregnancy BMI, was associated with the risk of MetS in midlife. An important mechanism involves a mother-to-child BMI transmission, independent of birth or perinatal conditions, socioeconomic characteristics and health behaviors over the lifecourse. However this mechanism is not sufficient for explaining the influence of mother’s pre-pregnancy BMI which implies the need to further explore other mechanisms in particular the role of genetics and early nutritional environment. ACE is not independently associated with MetS. However, other early life stressful events such as emergency caesarean deliveries and poor socioeconomic status during childhood may contribute as determinants of MetS.

Highlights

Lifecourse studies suggest that the metabolic syndrome (MetS) may be rooted in the early life environment
Metabolic syndrome (MetS) is a cluster of factors associated with a higher risk of type 2 diabetes, cardiovascular diseases and mortality [1, 2]
MetS was frequent, in particular in men among whom 37.5 % had MetS versus 19.8 % of women. This difference was mainly due to a higher proportion of high blood pressure in men as a higher proportion of triglycerides > =150 mg/dL, the proportion of high level for the other components of MetS being close in men and women (Table 1)

Summary

Introduction

Lifecourse studies suggest that the metabolic syndrome (MetS) may be rooted in the early life environment. Individuals whose parents had a higher BMI during their childhoods were more likely to be obese in adulthood [16] Such lifecourse studies on MetS are rarer, but evidence exists for a link between parental BMI and the subsequent risk for offspring to have higher levels of some components of MetS such as an atherosclerotic lipid profile [17]. This association seems to be explained only partially by adult lifestyles and lifetime socioeconomic position [16, 17]. Whatever the mechanisms involved in the parent–child BMI transmission, they deserve to be further studied

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