Module 2 - part 1 developmental origins of health and disease (DOHaD) Flashcards
time when nazi germany restricted food to the netherlands
The hunger winter (94/95)
the hunger winter
- well fed at conception, malnourished during final months
- born small
- stayed small whole lives
- below average obesity
*effects passed to grandchildren
the hunger winter
- malnourished first few months, well fed after
- large baby (fetus caught up)
- higher obesity rates
- numerous other health problems (mental health)
The Barker hypothesis
- aka DOHaD hypothesis
England and Whales study
“adverse influences early in development, and particularly during intrauterine life, can result in permanent changes in physiology and metabolism, which result in increased disease risk in adulthood”
- positive correlations between HD and infant mortality
- both sexes, all ages, different geographical regions
- adverse effects of poverty on maternal nutrition and lactation
- also seen in nodular goitre (iodine)
Nutritional perturbations during pregnancy
- trimester 1
- embryonic growth influenced by nutrients
- hyperglycemia (maternal diabetes) delays embryonic growth
Nutritional perturbations during pregnancy
- trimester 2
- complex relationship between fetus, placenta and mother
- nutrient deficiency affects placental function
Nutritional perturbations during pregnancy
- trimester 3
- undernutrition slows fetal growth to maintain placental function
- effects on fetus depend on duration
intrauterine environment influences
nutrient and O2 supply to fetus
undernutrition lowers which hormones
- affect
- treatment
fetal and placental hormones
- insulin, insulin-like growth factors (IGFs)
- affects pancreatic development
- glucose infusion fixes problem
relationship between placental weight and birth weight
- babies who develop diabetes have small placentas in relation to birthweight
causes of increased risk of developing adult disease
- how?
undernutrition
- hypoglycaemia
over nutrition
- hyperglycaemia
Others
- maternal contraint
- disease
- placental function
- imprinted genes
how
- changes in metabolism, hormone production and tissue sensitivity to hormones
Hypothesized mechanisms of increasing adult disease risk
- altered fetal nutrition
- exposure to stress / high levels of glucocorticoids
- thrifty phenotype hypothesis
- genetic / epigenetic influence
altered fetal nutrition
- under/over nutrition
- effects depend on
undernutrition
- reduced birth weight
- increased BP
- impaired glucose tollerance
over nutrition (high fat or high kcal)
- impaired glucose homeostasis
- hypertension
effects depend on
- offspring sex
- estrogen levels
- diet composition
- exposure to postnatal factors
exposure to stress / high levels of glucocorticoids
glucocorticoids
- dexamethasone (exogenous) and cortisol (endogenous - stress)
- high levels = low body weights, and high BP
normal function
- cortisol deactivated by 11beta-hydroxysteriod dehydrogenase 2 (11B-HSD2)
- doesnt block dexamethasone
- low levels, more active cortisol get in
thrift phenotype hypothesis
malnurished
- fetus lowers insulin levels so more glucose in blood for brain and heart
- reversible, but will make permanent changes if persist
- leads to T2D when in real world