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Fetal malnutrition and adult chronic disease
K Krishnaswamy1, A N Naidu, M P R Prasad
1National Institute of Nutrition, Hyderabad, AP, India.
Insights
Low-birth-weight (LBW) infants in India show higher risks for adult diseases like hypertension. While later-life nutrition may influence this, current findings suggest weak associations requiring further research.
Area of Science:
- Public Health
- Epidemiology
- Developmental Origins of Health and Disease (DOHaD)
Background:
- The fetal origins of adult disease hypothesis links early-life conditions to later health outcomes.
- Low-birth-weight (LBW) is associated with increased incidence of hypertension and impaired glucose tolerance.
- India faces a rising burden of non-communicable diseases, with a high prevalence of LBW.
Purpose of the Study:
- To investigate the association between LBW, later-life nutrition, and the risk of adult non-communicable diseases in an Indian cohort.
- To explore if improved nutrition in LBW individuals mitigates or exacerbates health risks.
Main Methods:
- A cohort study tracing individuals with accurate birth weights was conducted.
- Fifty low-birth-weight (LBW) and 78 normal birth weight (NBW) individuals were enrolled.
- Logistic regression analysis was used to assess the influence of various factors, including body mass index (BMI), on health outcomes.
Main Results:
- Odds ratio estimates for coronary heart disease and diabetes risk factors tended to be higher in better-nourished LBW individuals, but not statistically significant.
- Weight gain above the median of NBWs in LBW individuals also showed non-significant increases in risk factor estimates.
- Body mass index significantly influenced systolic and diastolic blood pressures in logistic regression models (P <0.007 and P <0.004, respectively).
Conclusions:
- The study found weak associations between LBW, subsequent nutrition, and adult disease risk factors in the studied Indian population.
- While BMI showed a significant impact on blood pressure, the overall evidence for the fetal origins of adult disease hypothesis in this context requires further investigation.
- More extensive research is necessary to establish a firm footing for the hypothesis in relation to LBW and adult disease in India.
Abstract:
Since the fetal origins of adult disease hypothesis was put forward, more than 30 studies around the world have indicated low-birth-weight (LBW) infants have a higher incidence of hypertension and impaired glucose tolerance. India ranks second in incidence of LBW among South East Asian countries and is experiencing a transition of disease pattern from communicable disease to non-communicable disease. Whether this could be explained in part by LBW infants who experienced better nutrition at a later age is explored here. An earlier cohort with accurate birth weights was traced and enrolled into the study. A sample of 50 LBW and 78 normal birth weight (NBW) individuals are reported on here. Though the odds ratio (OR) estimates of risk factors for coronary heart disease and diabetes tended to be higher in LBWs who were better nourished at the time of the study, they were not statistically different. Similarly, OR estimates for risk factors tended to be higher in LBWs who put on more weight than the median of NBWs, but they were not significant. Logistic regressions with several variables indicated significant influence of body mass index on systolic (P <0.007) and diastolic (P <0.004) blood pressures. Since the risk associations are weak, more studies are needed to put the hypothesis on a firm footing.