Abstract
For each individual, the genetic endowment at conception sets the limits on the capacity or metabolic function. The extent to which this capacity is achieved or constrained is determined by the environmental experience. The consequences of these experiences tend to be cumulative throughout life and express themselves phenotypically as achieved growth and body composition, hormonal status and the metabolic capacity for one or other function. At any time later in life the response to an environmental challenge, such as stress, infection or excess body weight is determined by an interaction amongst these factors. When the metabolic capacity to cope is exceeded, the limitation in function is exposed and expresses itself as overt disease. During early life and development the embryo, fetus and infant are relatively plastic in terms of metabolic function. The effect of any adverse environmental exposure is likely to be more marked than at later ages and the influence is more likely to exert a fundamental effect on the development of metabolic capacity. This has been characterised as “programming” and has come to be known as “the Barker hypothesis” or “the fetal origins hypothesis”. Barker has shown that the size and shape of the infant at birth has considerable statistical power to predict the risk of chronic disease in later life. These relationships are graded and operate across a range of birth weight, which would generally be considered to be normal, and are not simply a feature of the extreme of growth retardation. The first evidence showed strong relations between birth weight and heart disease, the risk factors for heart disease, diabetes and hypertension, and the intermediary markers for heart disease, blood cholesterol and fibrinogen. Strong associations have also been found for bone disease, allergic disease and some aspects of brain function. In experimental studies in animals it is possible to reproduce all of the metabolic features predicted from this hypothesis by moderating the consumption of food, or its pattern during pregnancy, and determining metabolic behaviour in the offspring. It has been shown that aspects of maternal diet exert an influence on fetal growth, especially the dietary intake of carbohydrate, protein and some micronutrients. However, these relationships are less strong than might have been predicted, especially when compared with the associations which can be drawn with maternal shape, size and metabolic capacity. Maternal height, weight and body composition relate to the metabolic capacity of the mother and her ability to provide an environment in which the delivery of nutrients to the fetus is optimal. Current evidence suggests that the size of the mothers determines her ability to support protein synthesis, and that maternal protein synthesis, especially visceral protein synthesis, is very closely related to fetal growth and development. It is not clear the extent to which the effect of an adverse environment in utero can be reversed by improved conditions postnatally, but some care is needed in exploring this area, as the evidence suggests that “catch-up” growth imposes its own metabolic stress and may in itself exert a harmful effect.
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Jackson, A.A. (1996) Perinatal nutrition: the impact on postnatal growth and development. In: Pediatrics and Perinatology, edited by Gluckman, P.D. and Heymann, M.A.London: Arnold, p. 298–303.
Jackson, A.A. (1985) Nutritional adaptation in disease and recovery. In: Nutritional adaptation in man. edited by Blaxter, K. and Waterlow, J.C.London: John Libbey, p. 111–126.
Jackson, A.A. (1992) How can early diet influence later disease? BNF Nutr Bull 17:23–30.
Barker, D.J.P. (1994) Mothers, babies and disease in later life. BMJ Publishiing Group.
Lucas, A. (1991) Programming by early nutrition in man. In: The childhood environment and adult disease, edited by Boch, G.R. and Whelan, J.Chichester: John Wiley & Sons, p. 38–55.
Jackson, A.A. and Wootton, S.A. (1990) The energy requirements of growth and catch-up growth. In: Activity, Energy Expenditure and Energy Requirements of Infants and Children. edited by Schurch, B. and Scrimshaw, N.S.Lausanne, Switzerland: IDECG, p. 185–214.
Uauy, R. and Alvear, J. (1992) Effects of protein-energy interactions on growth. In: Protein-energy interactions. edited by Scrimshaw, N.S. and Schurch, B.Lausanne, Switzerland: International Dietary Energy Consultative Group, p. 151–190.
Karlberg, J., Jalil, F., Lam, B., Low, L., and Yeung, C.Y. (1994) Linear growth retardation in relation to the three phases of growth. Eur J Clin Nutr 48(Supplement): S25–S44
Jackson, A.A. (1983) Amino acids: essential and non-essential. Lancet ii: 1034–1037.
Jackson, A.A. (1992) Protein metabolism in man. In: The Contribution of Nutrition to Human and Animal Health. edited by Widdowson, E.M. and Mathers, J.C. Cambridge: Cambridge University Press, p. 92–104.
Widdowson, E.M., Southgate, D.A.T., and Hey, E.M. (1979) Body composition of the fetus and infant. In: Nutrition and Metabolism of the Fetus and Infant. edited by Visser, H.A.K.The Hague: Martinus Nijhoff, p. 169–177.
Bennett, F.I. and Jackson, A.A. (1998) Glycine is not formed through the amino acid transferase reaction in human or rat placenta. Placenta 19:329–331.
Barker, D.J.P. (1994) The fetal origins of adult disease. Fetal and Maternal Medicine Review 6: 71–80.
Barker, D.J.P. and Osmond, C. (1986) Infant mortality, childhood nutrition, and ischaemic heart disease in England and Wales. Lancet i: 1077–1081.
Barker, D.J.P., Osmond, C., Simmonds, S.J., Wield, G.A. (1993) The relation of small head circumference and thinness at birth to death from cardiovascular disease in adult life. BMJ 306: 422–426.
Osmond, C., Barker, D.J.P., Winter, P.D., Fall, C.H.D., Simmonds, S.J. (1993) Early growth and death from cardiovascular disease in women. BMJ 307: 1519–1524.
Fall, C.H.D., Vijayakumar, M., Barker, D.J.P., Osmond, C., Duggleby, S. (1995) Weight in infancy and prevalence of coronary heart disease in adult life. BMJ 310: 17–19.
Barker, D.J.P., Martyn, C.N., Osmond, C., Hales, C.N., Fall, C.H. (1993) Growth in utero and serum cholesterol concentrations in adult life. BMJ 307: 1524–1527.
Fall, C.H.D., Osmond, C., Barker, D.J.P., et al. (1995) Fetal and infant growth and cardiovascular risk factors in women. BMJ 310: 428–432.
Martyn, C.N., Meade, T.W., Stirling, Y. and Barker, D.J.P. (1995) Plasma concentrations of fibrinogen and factor VII in adult life and their relation to intra-uterine growth. Br J Haematol 89: 142–146.
Barker, D.J.P. (1998). Mothers, babies and health in later life. Edinburgh: Churchill Livingstone.
Haste, F.M., Brooke, O.G., Anderson, H.R., and Bland, J.M. (1991) The effect of nutritional intake on outcome of pregnancy in smokers and non-smokers. Br J Nutr 65:347–354.
Godfrey, K., Robinson, S., Barker, D.J.P., Osmond, C. and Cox, V. (1996) Maternal nutrition in early and late pregnancy in relation to placental and fetal growth. BMJ 312: 410–414.
Mathews, F., Yudkin, P., and Neil, A. (1999) Influence of maternal nutrition on outcome of pregnancy: prospective cohort study. BMJ 319: 339–343.
Blaxter, K. and Waterlow, J.C. (1985) Nutritional adaptation in man. London: John.A. Libbey.
Godfrey, K.M., Forrester, T., Barker, D.J.P., Jackson, A.A., Landman, J.P., Hall, J.S.E., and Cox, V. (1994) Maternal nutritional status in pregnancy and blood pressure in childhood. Br J Obstet Gynaeco l101: 398–403.
Duggleby, S.L. and Jackson, A.A. (2000) Whole body protein turnover during pregnancy, maternal body composiiton and fetal outcome. Proc Nutr Soc, in the press (abstr).
Godfrey, K., Barker, D.J.P., Robinson, S., and Osmond, C. (1997) Maternal birthweight and diet in pregnancy in relation to the infant’s thinness at birth. BrJ Obstet Gynaecol 104:663–667.
Forsen, T., Eriksson, J.G., Tuomilehto, J., Teramo, K., Osmond, C., and Barker, D.J.P. (1997) Mother’s weight in pregnancy and coronary heart disease in a cohort of Finnish men: follow up study. BMJ 315: 837–840.
McCance, R.A. and Widdowson, E.M. (1974) The determinants of growth and form. ProcRoy Soc B 185: 1–17.
Winick, M. and Noble, A. (1996) Cellular response in rats during malnutrition. J Nutr 89:300–306.
Leprohon, C.E. and Anderson, G.H. (1980) Maternal diet affects feeding behaviour of self-selecting weanling rats. Physiol Behav 24: 553–559.
Anguita, R.M., Sigulem, D.M., and Sawaya, A.L. 1993. Intrauterine food restriction is associated with obesity in young rats. JNutr 123: 1421–1428.
Dahri, S., Reusens, B., Remacle, C., and Hoet, J.J. (1995) Nutritional influences on pancreatic development and potential links with non-insulin-dependent diabetes. Proc Nutr Soc 54: 345–356.
Levy, L. and Jackson, A.A. (1993) Modest restriction of dietary protein during pregnancy in the rat: fetal and placental growth. JDevel Physiol 19: 113–118.
Langley-Evans, S.C., Gardner, D.S., and Jackson, A.A. (1996) Disproportionate fetal growth in late gestation is associated with raised systolic blood pressure in later life. J Reprod Ferti l106: 307–312.
Langley, S.C. and Jackson, A.A. (1994) Increased systolic blood pressure in adult rats caused by fetal exposure to maternal low protein diets. Clin Sci 86:217–222.
McCarthy, H.D., Pickard, C.L., Speed, J., and Jackson, A.A. (1994) Sexual dimorphism of macronutrient selection and regional adipose tissue accumulation following in utero exposure to maternal low-protein diet. Proc Nutr Soc 53: 172A.
Pickard, C.L., McCarthy, H.D., Browne, R.F., and Jackson, A.A. (1996) Altered insulin response to a glucose load in rats following exposure to a low-protein diet in utero.. Proc Nutr Soc 55:44A.
Langley, S.C., Seakins, M., Grimble, R.F., and Jackson, A.A. (1994) The acute phase response of adult rats is altered by in utero exposure to maternal low protein diets. J Nutr 65:347–354.
Desai, M., Crowther, N.J., Ozanne, S.E., Lucas, A., and Hales, C.N. (1995) Adult glucose and lipid metabolism may be programmed during fetal life. Biochem Soc Transact 23: 331–335.
Langley-Evans, S.C., Welham, S.J.M., and Jackson, A.A. (1999) Fetal exposure to a meternal low protein diet impairs nephrogenesis and promotes hypertension in the rat. Life Sciences 64: 965–974.
Langley-Evans, S.C. (1996) Intrauterine programming of hypertension: nutrient interactions. Comp Biochem Physiol A Physiol 114A: 327–333.
Calder, P.C. and Yaqoob, P. (2000) The level of protein and type of fat in the diet of pregnant rats both affect lymphocyte function in the offspring. In the press.
Edwards, C.R.W., Benediktsson, R., Lindsay, R.S., and Seckl, J.R. (1993) Dysfunction of placental glucocorticoid barrier: link between fetal environment and adult hypertension. Lancet 341: 355–357.
Langley-Evans, S.C., Phillips, G.J., Benediktsson, R., Gardner, D.S., Edwards, C.R.W., Jackson, A.A., and Seckl, J.R. (1996) Protein intake in pregnancy, placental glucocorticoid metabolism and the programming of hypertension in the rat. Placenta 17:169–172.
Langley-Evans, S.C. (1999) Impact of maternal nutrition on the renin-angiotensin system in the fetal rat. In: Fetal Programming: Influences on Development and Disease in Later Life, edited by O’Brien, P.M.S., Wheeler, T. and Barker, D.J.P.London: RCOG, p. 374–388.
Langley-Evans, S.C. and Jackson, A.A. (1966). Intrauterine programming of hypertension: nutrient-hormone interactions. Nutriton Reviews 54: 163–169.
Gardner, D.S., Jackson, A.A., and Langley-Evans, S.C. (1998) The effect of prenatal diet and glucocorticoids on growth and systolic blood pressure in the rat. Proc Nutr Soc 57:235–240.
McCarty, R. and Fields-Okotcha, C. (1994) Timing of preweanling maternal effects on development of hypertension in SHR rats. Physiol Behav 55: 839–844.
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Jackson, A.A. (2002). Nutrients, Growth, and the Development of Programmed Metabolic Function. In: Koletzko, B., Michaelsen, K.F., Hernell, O. (eds) Short and Long Term Effects of Breast Feeding on Child Health. Advances in Experimental Medicine and Biology, vol 478. Springer, Boston, MA. https://doi.org/10.1007/0-306-46830-1_4
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DOI: https://doi.org/10.1007/0-306-46830-1_4
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