DEVELOPMENT ORIGINS OF HEALTH AND DISEASE

Begin before birth: “What happens during pregnancy can last a lifetime”

A throwback in the period when second world war finished in 1944-1945, we had a very big issue as the impact of this war. Yes, it is Starvation period. So many western people, especially in Netherland, suffering and have to eat anything that can be eaten such as tulip bulbs to survive. At that time, their food intake status had very low quality and quantity up to 800 kcal/day. This condition affected pregnant women and turned out have very long consequences for babies or children born during this hunger winter. This history is a very well-known example of the DEVELOPMENTAL ORIGINS OF HEALTH AND DISEASE HYPOTHESIS.

Children of women who were pregnant at this period, now already have 70 years of age and they have more susceptible to a chronic disease throughout their life. This condition is known as the theory of developmental origins of health and disease or fetal program hypothesis or Barker hypothesis (Barker et al., 1989). David Barker is a scientist who explored epidemiological study and found this theory during his research in England to determine the association between pregnancy outcome variables and cardiovascular disease in the later life. He found the association between smaller birthweight and cardiovascular disease and diabetes risks later in life. From this point of view, researchers start to focus on the first thousand days of life and this relationship with the risk of chronic disease. Another researcher reported that Dutch Hunger Winter study, which is based on the second world war (1944-1945), found most people who live in this period had very low food intake and not adequate to meet our daily energy requirements. Only 400-800 kcal they can afford due to the difficult situation and lack of food sources in the winter season.

Women who suffered starvation during their last trimester had direct effects resulting in lower birthweight. However, those children who born from women in the first and second trimester experienced higher rates of cardiovascular disease, depression, diabetes, kidney failure, and lung disease. So, this is a critical period of our life and our nutrition profile as pregnant women will definitely affect fetal organ growth and development during pregnancy. Foetal will adopt their intrauterine environment. Expecting starvation or lack of nutrition condition will be continued later in life and some compensations been made to adjust their growth (Thrifty phenotype). Therefore, will be an impact produced by this compensation and there were found unintentionally accompanied by imperfect organ development. By this explanation, we can conclude that what happens during pregnancy can last a lifetime.

This mismatch period, first thousand days of life, is affecting the risks of cardiometabolic diseases (Sales et al., 2017). The theory of developmental origins of health and disease provide a link between early life environment and disease risk later in life. What biological explanations will explain this condition? It could be Epigenetic process, which is changes in the genetic make-up that do not alter the DNA sequence, but that regulating which genes be turned on or off by gene expression mechanism.

References

Barker, D.J., Winter, P.D., Osmond, C., Margetts, B., Simmonds, S.J., 1989. Weight in infancy and death from ischaemic heart disease. Lancet 2, 577–580.

Sales, V.M., Ferguson-Smith, A.C., Patti, M.-E., 2017. Epigenetic Mechanisms of Transmission of Metabolic Disease across Generations. Cell Metab. 25, 559–571. https://doi.org/10.1016/j.cmet.2017.02.016