Research Article :
Hiroshi Bando Among various problems for diet and nutrition
worldwide, important concept has been Developmental Origins of Health and
Disease (DOHaD) theory or Fetal origins of Adult Disease (FOAD). DOHaD means
that predisposition to adult diseases has been formed in the interrelationship
between genes and the environment during fertilization, embryonic, fetal,
infancy, and adult periods. Related diseases include Atherosclerotic
Cardiovascular Disease (ASCVD), Diabetes Mellitus (DM), Chronic Kidney Disease (CKD),
and others. Low Birth Weight (LBW) babies have higher risk of disadvantage
states for disability, metabolic diseases and low educational achievement
later. Recognizing DOHaD in advance enables reduction of the predicting risks. For
decades, various problems have been continued for diet and nutrition
worldwide. Furthermore, lifestyle-related diseases and Non-Communicable
Diseases (NCDs) have been important for adequate management. Recent international
trend includes declining birthrate and increasing elderly population especially
in developed countries. Proper discussion from medical and social points of
view is required from fetus to centenarian period. In fact, there has been an
important concept, which is Developmental
Origins of Health and Disease (DOHaD) theory [1]. Another term can be used
as Fetal Origins of Adult Disease (FOAD) [2]. DOHaD or
FOAD has been recently in focus [3]. It was proposed by David Barker in 1986
[4]. The original perspective meant that predisposition to adult diseases has
been formed in the interrelationship between genes and the environment during
fertilization, embryonic, fetal, infancy periods and adults with a negative
lifestyle load after birth.
Various diseases may develop through certain mechanisms, which includes
predisposition with epigenetic shift and trans-generational effect [5]. Some
topics related to these will be described in this article. As to general perspective of DOHaD, birth
weight has been inversely related with the incidence of later lifestyle-related
diseases for adult life. Especially, several diseases
have been found such as Atherosclerotic Cardiovascular Disease (ASCVD), Diabetes
Mellitus (DM), Chronic Kidney Disease (CKD) and so on [6]. Lower Birth
Weight (LBW) may be occurred due to various undesired intrauterine
environments, including stress, malnutrition, alcohol drinking and smoking. DOHaD
theory has been known to originate from fertilization to neonatal period that
interacts between human genes and some environments such as stress, nutrition
and environmental chemicals. Historically, the related episodes of DOHaD and
Dutch Hunger Winter (1944-1945) and Great Leap Forward in China (1959-1961)
were observed [7]. Several
diseases have been known which showed increased risk from LBW [8]. They include
hypertension, cardiovascular disease, impaired glucose
tolerance, Type 2 Diabetes (T2D), metabolic syndrome, osteoporosis,
dyslipidemia, psychoneurological abnormalities, Chronic Obstructive Pulmonary
Disease (COPD), early menopause, short stature due to Small-for-Gestational Age
(SGA), pregnancy
complications and others. LBW babies have higher risk of disadvantage states
for disability, metabolic diseases and low educational achievement in the
future than normal birth weight babies. As to a retrospective study, 4224
babies followed up at university hospital for 6 years were analyzed [9]. The
ratio of LBW was 1028 cases (24%), and 231 out of 1028 were born from multiple
pregnancies. Among 797 singleton cases, 518 (65%) was born in preterm
situation. For LBW
infants, higher risk in later life has been observed for developing increased
insulin resistance and related comorbidities. In the light of DOHaD concept,
intrauterine and postnatal environments may indicate an important role for
elevating these risks. LBW infants, however, show additional characteristics,
in which they are not necessarily obese or overweight during their life [10].
There may be inconsistency to show thrifty phenotype that is related to lower
lean body mass and impaired growth course. Regarding LBW infants, detail investigation
was conducted by socio-economic survey [11]. The results included as follows: i) Poor grades and performances in school
age: Generally, total score of English and mathematics was 25% or more lower in
the O-level test. By
recognizing the DOHaD theory in advance, it is possible to reduce the
predicting risks during bringing up the child. For continuing DOHaD research,
to develop preferable situation will be expected where some kinds of
intervention can be performed. The possible trials are as follows: People who had malnutrition in earlier life
show higher risk for ASCVD [16]. A study was conducted whether improved
nutrition can predict cardio metabolic function. Subjects were 1027 cases, and
22.9% were provided improved nutrition in the first 1000 days from pregnancy to
2-year birthday [17]. The protocol included a mixed-component meal tolerance
challenge with post-prandial response of glucose, insulin and others. The
results showed more favorable glucose response in the group of early exposure
of improved nutrition.
In summary, the topic of DOHaD theory was
described. Developmental physiology has 3 categories, including promoting
conceptual advances, demonstrating broad relevance and improving experimental
approaches [18]. These fields will develop challenge and great opportunity in
the future. Hiroshi Bando, Tokushima University/Medical
Research, Nakashowa 1-61, Tokushima 770-0943, Japan, Tel: +81-90-3187-2485, E-mail: pianomed@bronze.ocn.ne.jp
Bando H. Various influence for nutritional
status by the developmental origins of health and disease (DOHaD) theory (2021)
Edel
J Biomed Res Rev 3: 28-29 Epigenetic Shift, Circadian Clock GenesVarious Influence for Nutritional Status by the Developmental Origins of Health and Disease (DOHaD) Theory
Abstract
Full-Text
ii) Social development: They
showed lower scores of intellectual development and also social development
score.
iii) Wages for working in adult:
Their wages for working during adult period are low, and the unemployed rate at
the age of 33 is higher.
The emaciation status of young female will bring a variety of problems from
medical, social and economic points of view. They include the following.
i. Her life for long years:
Various diseases will increase from young to elderly period [12]. They include
decreased ovarian
function, irregular menstruation, amenorrhea (1st and 2nd), decreased
Quality Of Life (QOL), and decreased neuropsychiatric disfunction in older age,
and increased risk of diseases and impaired states.
ii. Disadvantageous impact on the
next generation: Epigenetics changes due to under nutrition in the fetus [13].
Therefore, the predisposition to disease is transmitted across the generations.
Furthermore, the risk of some illness
in the next generation will increase and the QOL/ADL due to illness will be
affected associated with elevated medical expenses.
iii. Unbeneficial influences on
society: This kind of future problem seems to be more serious than simply
imbalance of the population with decreasing birthrate and increasing elderly
[14]. In other words, several crucial impacts will be found such as
productivity declines, socio-economic stagnation, increased medical costs, and
changes in disease structure.
i) Breastfeeding
and physical contact: physical contact (skinship) has been important even if
the mother is unable to breastfeed.
ii) Regular lifestyle: Establish a
habit of early going to bed, rising and breakfast from childhood. Always think
about the existence and effects of circadian clock genes in human [15].
iii) Exercise habits: Get the
joyous feeling of moving the body from younger period and continuing sports for
the rest of your life.
iv) Weight gain in the first half year:
Changes in body
weight, especially for 0-6 months are important. For this period, use the
growth/development chart and consult with a specialist including a
pediatrician.
v) Treatment method: Currently,
some medical agents have been under research and development. References
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