Endocrine Abstracts (2009) 19 S12

Consequences of unbalanced maternal nutrition

Mark Hanson

Southampton General Hospital, Southampton, UK.

A critical aspect of the environment before birth and in infancy is nutrition. It is estimated that 850 m people in the world (820 m in developing countries) are hungry. This has long-term consequences for their later health and economic potential but also for their children. Such figures do not include those people who have unbalanced nutrition, both in terms of macronutrients and micronutrients. An unbalanced diet can lead to ‘malnutrition’ even in those who have access to plentiful food: in developed societies many women consume poor quality diets, resulting in nutritional deficiencies on one hand, or overweight and obesity on the other. Whilst maternal under-nutrition remains a major problem in developing societies, maternal overweight is also becoming a concern. Unbalanced nutrition has effects on development across a broad dietary spectrum. Animal studies reveal how maternal nutrition affects developing offspring phenotype, via changes in endocrine, cardiovascular and metabolic control, which prepare the offspring for a predicted postnatal environment. Where developmental cues (nutritional, endocrine etc) are inappropriate, or environment changes between generations, the phenotype is mismatched, increasing disease risk. Pathological changes in phenotype are also induced by more severe under- or overnutrition. Phenotypic plasticity is mediated in part by epigenetic processes involving DNA methylation, histone structure and small non-coding RNAs, controlling gene expression beyond just imprinted genes. Epigenetic marks can be passed to more than just the next generation. Because such epigenetic processes can act on promoter regions of genes, their effects may not be manifest until later in the lifecourse via inappropriate responses to environmental challenges. Experimentally, such processes can be reversed by endocrine, pharmacological or nutritional interventions during the developmental plastic period. The DOHaD agenda therefore aims to promote balanced maternal and infant nutrition as a means to reducing future chronic non-communicable disease.

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