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Coronary heart disease: a disorder of growth
1MRC Environmental Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK. djpb@mrc.soton.ac.uk
Insights
Altered fetal and infant growth is linked to adult diseases like coronary heart disease, type 2 diabetes, hypertension, and stroke. Protecting early growth and optimizing maternal nutrition are key for prevention.
Area of Science:
- Developmental origins of health and disease (DOHaD)
- Cardiovascular and metabolic disease research
Background:
- Coronary heart disease, type 2 diabetes, hypertension, and stroke share common origins.
- Altered growth in utero, infancy, and childhood is increasingly recognized as a precursor to these chronic diseases.
Purpose of the Study:
- To introduce a developmental model for understanding the origins of major chronic diseases.
- To highlight the role of early life growth and nutrition in disease susceptibility.
Main Methods:
- Review and synthesis of emerging research on early life growth and later disease outcomes.
- Focus on the impact of fetal and infant nutrition and growth trajectories.
Main Results:
- Evidence suggests altered fetal and infant growth patterns are associated with increased risk of coronary heart disease, type 2 diabetes, hypertension, and stroke.
- Suboptimal fetal and infant nutrition, even in well-nourished populations, contributes to vulnerability.
Conclusions:
- Protecting infant growth and preventing rapid weight gain in vulnerable children are immediate preventive strategies.
- Optimizing maternal diet and nutritional status before and during pregnancy is crucial for long-term disease prevention.
Abstract:
A new 'developmental' model for the origins of coronary heart disease and the related disorders of type 2 diabetes, hypertension and stroke is emerging. The finding that people who develop these disorders have altered growth in utero, during infancy and childhood provides a new starting point for research. The immediate prospect for prevention is through protecting infant growth and preventing accelerated weight gain in children made vulnerable to later disease by small size at birth and during infancy. Ultimately we need to optimize maternal diet and composition before and during pregnancy. Despite current levels of nutrition in Western countries the nutrition of many fetuses and infants remains suboptimal because the nutrients available are unbalanced or because their delivery is constrained by the long and vulnerable fetal supply line.