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The Indian Journal of Pediatrics

, Volume 85, Issue 6, pp 472–477 | Cite as

Early Life Origins of Obesity and Related Complications

  • Atul Singhal
Review Article

Abstract

The idea that nutrition in early life (such as before conception, during pregnancy and in infancy) can influence, or programme, long-term health, known as the ‘Developmental Origins of Health and Disease Hypothesis’, has generated great scientific interest. This concept is particularly relevant for the development of obesity and its complications, arguably the most important public health issue of the twenty-first century worldwide. The concept is strongly supported by evidence from animal studies, both observational and experimental (randomised) studies in humans, and is highly relevant for population health in both low-income and high-incomes countries. For instance, optimising nutrition in pregnancy (both in terms of under-nutrition and over-nutrition) and preventing too fast infant weight gain have been shown to reduce the risk of future obesity. Proposed mechanisms have included effects of early nutrition on the epigenome, hormones such as insulin, and regulation of appetite, that effect long-term risk of obesity. Although further data from experimental studies is required to support a causal link between early nutrition and future adiposity, the developmental origins hypothesis is already changing health policy and practice globally. The present review considers the evidence for the developmental origins of obesity, the mechanisms involved, and the implications for public health.

Keywords

Obesity Programming Development Infant growth Breast-feeding 

Notes

Acknowledgements

A. Singhal is supported by Great Ormond Street Hospital Children’s Charity and is a Stellenbosch Institute for Advanced Study (STIAS) Fellow, Wallenberg Research Centre at Stellenbosch University, Stellenbosch 7600, South Africa.

Compliance with Ethical Standards

Conflict of Interest

None.

Source of Funding

Atul Singhal is supported by Great Ormond Street Hospital Children’s Charity.

References

  1. 1.
    Heymsfield SB, Wadden TA. Mechanisms, pathophysiology, and management of obesity. N Engl J Med. 2017;376:254–66.CrossRefPubMedGoogle Scholar
  2. 2.
    Hanson M, Mullins E, Modi N. Time for the UK to commit to tackling child obesity. BMJ. 2017;356:j762.CrossRefPubMedGoogle Scholar
  3. 3.
    Baird J, Jacob C, Barker M, et al. Developmental origins of health and disease: a lifecourse approach to the prevention of non-communicable diseases. Healthcare (Basel). 2017;5.pii:E14.Google Scholar
  4. 4.
    Lucas A. Programming by early nutrition in man. In: Bock GR, Whelan J, editors. The Childhood Environment and Adult Disease. (CIBA Foundation Symposium 156): Chichester, UK: Whiley; 1991. p. 38–55.Google Scholar
  5. 5.
    Singhal A. The role of infant nutrition in the global epidemic of non-communicable disease. Proc Nutr Soc. 2016;75:162–8.CrossRefPubMedGoogle Scholar
  6. 6.
    Jain V, Singhal A. Catch up growth in low birth weight infants: striking a healthy balance. Rev Endocr Metab Disord. 2012;13:141–7.CrossRefPubMedGoogle Scholar
  7. 7.
    Tomar AS, Tallapragada DS, Nongmaithem SS, et al. Intrauterine programming of diabetes and adiposity. Curr Obes Rep. 2015;4:418–28.CrossRefPubMedGoogle Scholar
  8. 8.
    Crowther NJ. Early determinants of chronic disease in developing countries. Best Pract Res Clin Endocrinol Metab. 2012;26:655–65.CrossRefPubMedGoogle Scholar
  9. 9.
    Reddy SP, Mbewu AD. The implications of the developmental origins of health and disease on public health policy and health promotion in South Africa. Healthcare (Basel). 2016;4.pii:E83.Google Scholar
  10. 10.
    Barker DJ, Winter PD, Osmond C, Margetts B, Simmonds SJ. Weight in infancy and death from ischaemic heart disease. Lancet. 1989;2:577–80.CrossRefPubMedGoogle Scholar
  11. 11.
    Barker DJP. Fetal origins of coronary heart disease. BMJ. 1995;311:171–4.CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Oken E, Gillman MW. Fetal origins of obesity. Obes Res. 2003;11:496–506.CrossRefPubMedGoogle Scholar
  13. 13.
    Bateson P, Barker D, Clutton-Brock T, et al. Developmental plasticity and human health. Nature. 2004;430:419–21.CrossRefPubMedGoogle Scholar
  14. 14.
    Hanson MA, Gluckman PD. Developmental processes and the induction of cardiovascular function: conceptual aspects. J Physiol. 2005;565:27–34.CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Hales CN, Barker DJ. Type 2 (non-insulin-dependent) diabetes mellitus: the thrifty phenotype hypothesis. Diabetologia. 1992;35:595–601.CrossRefPubMedGoogle Scholar
  16. 16.
    Hattersley AT, Beards F, Ballantyne E, et al. Mutations in the glucokinase gene of the fetus result in reduced birth weight. Nat Genet. 1998;19:268–70.CrossRefPubMedGoogle Scholar
  17. 17.
    Horikoshi M, Beaumont RN, Day FR, et al. Genome-wide associations for birth weight and correlations with adult disease. Nature. 2016;538:248–52.CrossRefPubMedPubMedCentralGoogle Scholar
  18. 18.
    Singhal A, Lucas A. Early origins of cardiovascular disease; is there a unifying hypothesis? Lancet. 2004;363:1642–5.CrossRefPubMedGoogle Scholar
  19. 19.
    Ozanne SE, Hales N. Lifespan: catch-up growth and obesity in male mice. Nature. 2004;427:411–2.CrossRefPubMedGoogle Scholar
  20. 20.
    Metcalfe NB, Monaghan P. Compensation for a bad start: grow now, pay later? Trends Ecol Evol. 2001;16:254–60.CrossRefPubMedGoogle Scholar
  21. 21.
    Whincup PH, Kaye SJ, Owen CG, et al. Birth weight and risk of type 2 diabetes: a systematic review. JAMA. 2008;300:2886–97.CrossRefPubMedGoogle Scholar
  22. 22.
    Fall CH. Fetal malnutrition and long-term outcomes. Nestle Nutr Inst Workshop Ser. 2013;74:11–25.CrossRefPubMedPubMedCentralGoogle Scholar
  23. 23.
    Haider BA, Bhutta ZA. Multiple-micronutrient supplementation for women during pregnancy. Cochrane Database Syst Rev. 2015;11:CD004905.Google Scholar
  24. 24.
    Ota E, Hori H, Mori R, Tobe-Gai R, Farrar D. Antenatal dietary education and supplementation to increase energy and protein intake. Cochrane Database Syst Rev. 2015;6:CD000032.Google Scholar
  25. 25.
    Devakumar D, Fall CH, Sachdev HS, et al. Maternal antenatal multiple micronutrient supplementation for long-term health benefits in children: a systematic review and meta-analysis. BMC Med. 2016;14:90.CrossRefPubMedPubMedCentralGoogle Scholar
  26. 26.
    Potdar RD, Sahariah SA, Gandhi M, et al. Improving women's diet quality preconceptionally and during gestation: effects on birth weight and prevalence of low birth weight--a randomized controlled efficacy trial in India (Mumbai maternal nutrition project). Am J Clin Nutr. 2014;100:1257–68.CrossRefPubMedPubMedCentralGoogle Scholar
  27. 27.
    Hawkesworth S. Conference on "multidisciplinary approaches to nutritional problems". Postgraduate symposium. Exploiting dietary supplementation trials to assess the impact of the prenatal environment on CVD risk. Proc Nutr Soc. 2009;68:78–88.CrossRefPubMedGoogle Scholar
  28. 28.
    Godfrey KM, Reynolds RM, Prescott SL, et al. Influence of maternal obesity on the long-term health of offspring. Lancet Diabetes Endocrinol. 2017;5:53–64.CrossRefPubMedGoogle Scholar
  29. 29.
    Woo Baidal JA, Locks LM, Cheng ER, et al. Risk factors for childhood obesity in the first 1,000 days: a systematic review. Am J Prev Med. 2016;50:761–79.CrossRefPubMedGoogle Scholar
  30. 30.
    Smith J, Cianflone K, Biron S, et al. Effects of maternal surgical weight loss in mothers on intergenerational transmission of obesity. J Clin Endocrinol Metab. 2009;94:4275–83.CrossRefPubMedGoogle Scholar
  31. 31.
    Patro B, Liber A, Zalewski B, et al. Maternal and paternal body mass index and offspring obesity: a systematic review. Ann Nutr Metab. 2013;63:32–41.CrossRefPubMedGoogle Scholar
  32. 32.
    Dodd JM, Grivell RM, Louise J, et al. The effects of dietary and lifestyle interventions among pregnant women who are overweight or obese on longer-term maternal and early childhood outcomes: protocol for an individual participant data (IPD) meta-analysis. Syst Rev. 2017;6:51.CrossRefPubMedPubMedCentralGoogle Scholar
  33. 33.
    Patel N, Godfrey KM, Pasupathy D, et al. Infant adiposity following a randomised controlled trial of a behavioural intervention in obese pregnancy. Int J Obes. 2017;41:1018–26.Google Scholar
  34. 34.
    Patro-Gołąb B, Zalewski BM, Kołodziej M, et al. Nutritional interventions or exposures in infants and children aged up to 3 years and their effects on subsequent risk of overweight, obesity and body fat: a systematic review of systematic reviews. Obes Rev. 2016;17:1245–57.CrossRefPubMedPubMedCentralGoogle Scholar
  35. 35.
    Singhal A, Lanigan J. Breastfeeding, early growth and later obesity. Obes Rev. 2007;8:51–4.CrossRefPubMedGoogle Scholar
  36. 36.
    Weber M, Grote V, Closa-Monasterolo R, et al. Lower protein content in infant formula reduces BMI and obesity risk at school age: follow-up of a randomized trial. Am J Clin Nutr. 2014;99:1041–51.CrossRefPubMedGoogle Scholar
  37. 37.
    Gruszfeld D, Weber M, Gradowska K, et al; European Childhood Obesity Study Group. Association of early protein intake and pre-peritoneal fat at five years of age: follow-up of a randomized clinical trial. Nutr Metab Cardiovasc Dis. 2016;26:824–32.Google Scholar
  38. 38.
    Savage JS, Birch LL, Marini M, Anzman-Frasca S, Paul IM. Effect of the INSIGHT responsive parenting intervention on rapid infant weight gain and overweight status at age 1 year: a randomized clinical trial. JAMA Pediatr. 2016;170:742–9.CrossRefPubMedPubMedCentralGoogle Scholar
  39. 39.
    Fewtrell M, Bronsky J, Campoy C, et al. Complementary feeding: a position paper by the European Society for Paediatric Gastroenterology, hepatology, and nutrition (ESPGHAN) committee on nutrition. J Pediatr Gastroenterol Nutr. 2017;64:119–32.CrossRefPubMedGoogle Scholar
  40. 40.
    Rolland-Cachera MF, Akrout M, Péneau S. Nutrient intakes in early life and risk of obesity. Int J Environ Res Public Health. 2016;13. Pii:E564.Google Scholar
  41. 41.
    Cole TJ. Children grow and horses race: is the adiposity rebound a critical period for later obesity? BMC Pediatr. 2004;4:6.CrossRefPubMedPubMedCentralGoogle Scholar
  42. 42.
    Michaelsen KF, Greer FR. Protein needs early in life and long-term health. Am J Clin Nutr. 2014;99:718S–22S.CrossRefPubMedGoogle Scholar
  43. 43.
    Elks CE, Heude B, de Zegher F, et al. Associations between genetic obesity susceptibility and early postnatal fat and lean mass: an individual participant meta-analysis. JAMA Pediatr. 2014;168:1122–30.CrossRefPubMedGoogle Scholar
  44. 44.
    Ramamoorthy TG, Begum G, Harno E, White A. Developmental programming of hypothalamic neuronal circuits: impact on energy balance control. Front Neurosci. 2015;9:126.Google Scholar
  45. 45.
    Alexander DD, Yan J, Bylsma LC, et al. Growth of infants consuming whey-predominant term infant formulas with a protein content of 1.8 g/100 kcal: a multicenter pooled analysis of individual participant data. Am J Clin Nutr. 2016;104:1083–92.CrossRefPubMedGoogle Scholar

Copyright information

© Dr. K C Chaudhuri Foundation 2017

Authors and Affiliations

  1. 1.The Childhood Nutrition Research Centre; Population, Policy and Practice ProgrammeUCL Great Ormond Street Institute of Child HealthLondonUK

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