Cutting the risk of coronary disease - start before birth says UK doctor

Lausanne, Switzerland: Modest improvements in foetal and infant growth would lead to substantial falls in disease rates in later life, an international conference in reproductive medicine heard today (Monday 2 July).

Professor David Barker told the European Society of Human Reproduction and Embryology that prevention of conditions such as coronary heart disease, stroke, non-insulin dependent diabetes and high blood pressure might ultimately depend on changing the body composition and diets of young women and preventing imbalances between pre and postnatal growth in children.

Professor Barker, who is Director of the UK's Medical Research Council Environmental Epidemiology Unit at Southampton University, is an exponent of foetal origin hypothesis, which proposes that these diseases originate through adaptations that the foetus and infant make when they are undernourished.

The adaptations included diversion of oxygenated blood away from the trunk to the brain, alterations in the hormonal systems that regulate growth and maturation and in body composition.

Professor Barker said that, among men, the highest death rates from coronary heart disease were in those who were thin at birth and at one year but whose weight gain accelerated in childhood so that they had an above average body mass. Death from coronary heart disease may therefore be a consequence of poor prenatal or infant nutrition followed by improved nutrition in early childhood.

"The amount of fat in the body in relation to muscle may explain the increased risk. Boys who were thin at birth will always have comparatively fewer muscle cells because the numbers of muscle cells are determined before birth. Rapid weight gain may lead to a body with a high proportion of fat in relation to muscle and we know that is unhealthy in later life."

Other patterns of foetal and childhood growth were associated with the later development of stroke, non-insulin dependent diabete

Contact: Margaret Willson
European Society for Human Reproduction and Embryology

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