Early influences fuel later obesity

“Obesity is better prevented early than inadequately treated later in life,” says Liggins Institute Director Professor Wayne Cutfield, who is a keynote speaker at the Australia and New Zealand Obesity Society conference in Auckland this week.

The conference theme is “For our children’s children” and in his presentations Professor Cutfield challenges popular misconceptions that our health depends on our genes and our lifestyle, particularly in middle age. Rather, he says, events early in life are critically important.

Data from researchers at the Liggins Institute, the National Research Centre for Growth and Development (NRCGD) and their international colleagues point firmly to the importance of factors in the pre-birth environment.

“The optimal fetal environment is delicately poised,” says Cutfield,” and even small deviations from a normal pattern of development can have a significant impact, increasing the risk of obesity-related diseases and diabetes.

“The fetal nutritional environment from before conception and throughout pregnancy is critically important for health lifelong.”

Children born small for their gestational age, preterm, post term and to women who experienced extreme morning sickness have all been shown to have increased risks of later obesity, cardiovascular and metabolic diseases such as diabetes. Even the near 60% of the population who are first-borns may have small but contributing risk factors for diabetes and high blood pressure.

Cutfield says nutrition during pregnancy has a huge impact: while the previous examples represent potentially reduced nutrition, an overweight mother is likely to oversupply nutrients to her fetus, resulting in a large baby and initiating a cycle of obesity through overweight child, young woman and mother.

“We know who is at risk and how, and these are potentially preventable,” he says. “But we need to understand better what defines optimal nutrition in pregnancy, particularly what the optimal micronutrient consumption is.

“We need to improve education for planning of pregnancy and nutrition in pregnancy, beginning in the early teenage years.”

He suggests that given the critical and cumulative impact of early life events, GPs should routinely include these factors in the “score cards” they use for assessing health and disease risk.

Professor Cutfield’s messages are reinforced in presentations at the conference by other Liggins Institute and NRCGD researchers Associate Professor Frank Bloomfield and Dr Mark Vickers.

Dr Bloomfield will present evidence from studies in sheep demonstrating that both moderate maternal under-nutrition prior to conception and being conceived as a twin have an impact on fetal development, postnatal growth and adult fat deposition and that these effects are mediated through epigenetic mechanisms.

Dr Vickers will also discuss the early life origins of adult obesity and associated metabolic disorders and introduce experimental evidence suggesting critical windows during early development when it may be possible to intervene to reduce inevitable progress to adult obesity.