Nutritional Programming

Question 1

Foetal Growth
- 3 stages and nutrition requirements

Answer 1

-The zygote: no increased requirements
- The early embryo: 6 week period, no increase in energy requirements, but nutrient intake v important, folate supps minimise neural tube defects in 17-30 days gestation period
- The foetal period: 7 months, energy & protein requirements increase

Question 3

Nutritional Programming - Barker’s Hypothesis

Answer 3

• associations between low
  birth weight and later disease risk including CHD, hypertension, metabolic
  syndrome occurrence and type II diabetes

Question 4

Dutch Famine
- babies
- first trimester
- mid-gestation

Answer 4

• Babies had higher risk of obesity,
  increased circulating lipids, DMII risk
  later in life if they were exposed to the
  famine during the first trimester
  Increased risk of impaired renal function
  as adults when exposed to famine
  during mid-gestation.

Question 5

Siege of Leningrad
- babies

Answer 5

Babies Did NOT have higher risk of
obesity, CVD etc in later life

Question 6

“The ______ _________ hypothesis proposes that the epidemiological
associations between poor foetal and infant growth and the
subsequent development of type 2 diabetes and the metabolic
syndrome result from the effects of ______ ________ in _____ ____, which
produces permanent changes in _______-______ metabolism.”

Answer 6

thrifty phenotype
poor nutrition
early life
glucose-insulin

Question 6

THE THRIFTY PHENOTYPE
HYPOTHESIS
While in-utero “______” enables humans to receive a
“_______ _______” from their mothers, preparing them for the
world they will live in.

Answer 6

plasticity
weather forecast

Question 7

WHY WOULD UNDERNUTRITION INCREASE
RISK OF DISEASE ASSOC WITH OBESITY?

Answer 7

1. Fewer cells in organs
2. Altered hormones & metabolism
3. Increased vulnerability to adverse environmental influences in later life

Question 7

Overnutrition risks for the mother

Answer 7

High blood pressure
Pre-eclampsia
Miscarriage & still-birth
Gestational diabetes
Caesarean sections
Difficultly losing weight after
birth

Question 8

Overnutrition risks for the offspring

Answer 8

Congenital abnormalities
Small for gestational age
Foetal overgrowth
Preterm birth & neonatal
mortality
Childhood obesity
Adult obesity
DMII
Metabolic Syndrome

Question 9

Overnutriton and Raised blood glucose

Answer 9

Even in non-diabetic, obese women have higher
blood glucose levels → foetal hyperinsulinemia, enhanced glycogenesis &
lipogenesis → ↑adipose tissue → ↓ insulin sensitivity

Question 10

Overnutrition and altered feeding behaviours
- animal studies

Answer 10

Animal studies indicate maternal obesity is
linked with ↑ appetite in the off-spring

Question 11

Overnutrition and increased fat intake
- rats

Answer 11

Offspring of rats fed high fat diets had increased
risk of dyslipidemia, hyperinsulinemia, insulin resistance and CVD and DM
II

Question 12

The Boyd Orr study results

Answer 12

• Significantly lower overall mortality in
  persons in the highest total dairy and
  milk intake groups in childhood
• Significantly lower risk of stroke
  mortality and lower all‐cause
  mortality in those who had the
  highest childhood calcium intake