L12 Chronic Diseases

Question 1

what are the potential origins of western diseases

Answer 1

consequence of environmental changes accompanying industrialisation and prosperity

Question 2

what are the two major environmental changes during industrialisation

Answer 2

1. Hygiene
2. Diet
   • - Improvements in sanitisation – fall in mortality rate form infective diseases (esp. children)
   • - Increased total calories, animal fat, fruit, fresh vegetables, vitamins, minerals – better growth and development (esp. children) and decline in infective diseases

Question 3

childhood / early life factors of cardio vascular disease of T2D

Answer 3

• Tended to grow slowly in utero (birthweights toward lower end of normal)
• Tended to remain small for first 2yrs after birth and throughout infancy
• After that, they gained weight and body mass index rapidly

Question 4

Describe programming

Answer 4

Developmental plasticity

= adverse influences can permanently change body structure and function = ‘programming’

Question 5

describe compensatory growth

Answer 5

• • If developmental growth falters due to malnutrition, it has ability - once adversity has ceased - to return to its growth trajectory by accelerated (compensatory) growth
• • If energy is allocated to rapid growth, allocation to some other developmental activity is reduced
• • In animals, compensatory growth has a wide range of physiological and metabolic costs that include premature death
• • costs of compensatory growth effects lifespan

Question 6

what is size at birth due to

Answer 6

product of fetus’s trajectory of growth (set at early developmental stage) and maternoplacental capacity to supply sufficient nutrients to maintain this trajectory
• - Rapid trajectory of growth increases fetus’ demand for nutrients (greatest late in pregnancy)

Question 7

link between placenta size and metal nutirtion

Answer 7

• - Depends on mother’s nutrition (diet, nutritional stores,
metabolism), which is the product of her lifetime’s nutrition (Jackson, 2000)
• - Depends on placenta’s ability to transport nutrients from mother to fetus (Harding, 2001), and is reflected in its size
• - Small babies generally have small placentas
• - Trajectory of fetal growth thought to increase with improvements in peri-conceptional nutrition

Question 8

explain risk of male under development and placental condition

Answer 8

• males placenta= less reserve capacity > increase vulnerability to under nutrition

Question 9

what causes intrauterine growth restriction

Answer 9

developmental insult = placental changes (via poor nutrition) + maternal changes (execs corticoid exposure)

Question 10

explain steps of developmental programming of obesity

Answer 10

1. maternal exposures (substance abuse, poor nutrition, stress, smoking)
2. developing fetes (growth restriction, increased fat storage)
3. neonates (postnatal over nutrition, catch up growth, higher body weight)
4. adult (phenotypic outcomes)
   metabolic syndromes= obesity

Question 11

how can development of metabolic syndrome (post programming) be exacerbated

Answer 11

programmed physiology is challenged by excess nutritional load (e.g. high fat western diet) - underlying pathology may be exacerbated

Question 12

glucocorticoid exposure =

Answer 12

decreased placental growth

+ HPA axis

Question 13

developmental origins of CD

Answer 13

effect of intra-uterine or early postnatal development

• Many babies in utero receiving unbalanced and inadequate diets