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Birth weight, malnutrition and kidney-associated outcomes--a global concern
Valerie A Luyckx1, Barry M Brenner2
1Institute of Biomedical Ethics, University of Zurich, 78 Lerchenbergstrasse, Erlenbach 8703, Switzerland.
Insights
Adverse early life environments, including nutrition, can program later-life hypertension and kidney disease. Interventions targeting these developmental risks are crucial for global health.
Area of Science:
- Developmental origins of health and disease
- Perinatal programming
- Chronic disease epidemiology
Background:
- Adverse intrauterine environments increase risks for hypertension and kidney disease later in life.
- While low birth weight is a known marker, high birth weight and rapid childhood growth are also emerging risk factors.
- Altered nephron number programming links developmental stressors to chronic disease risk.
Purpose of the Study:
- To highlight the role of maternal, fetal, and childhood nutrition in developmental programming.
- To examine how sequential undernutrition and overnutrition in resource-poor settings augment chronic disease risk.
- To emphasize the need to understand long-term benefits of nutritional interventions.
Main Methods:
- Review of existing literature on developmental programming and chronic disease.
- Analysis of the impact of nutritional factors across different life stages.
- Examination of epidemiological data from resource-poor countries.
Main Results:
- Maternal and childhood nutrition significantly influence nephron number programming.
- Sequential nutritional imbalances exacerbate developmental programming effects.
- Nutritional interventions show promise in reducing short-term risks like low birth weight.
Conclusions:
- Understanding long-term benefits of nutritional interventions is key to policy development.
- Interrupting the developmental programming cycle can combat global hypertension and kidney disease epidemics.
- Addressing nutritional factors from fetal development through childhood is critical for prevention.
Abstract:
An adverse intrauterine environment is associated with an increased risk of elevated blood pressure and kidney disease in later life. Many studies have focused on low birth weight, prematurity and growth restriction as surrogate markers of an adverse intrauterine environment; however, high birth weight, exposure to maternal diabetes and rapid growth during early childhood are also emerging as developmental risk factors for chronic diseases. Altered programming of nephron number is an important link between exposure to developmental stressors and subsequent risk of hypertension and kidney disease. Maternal, fetal, and childhood nutrition are crucial contributors to these programming effects. Resource-poor countries experience the sequential burdens of fetal and childhood undernutrition and subsequent overnutrition, which synergistically act to augment the effects of developmental programming; this observation might explain in part the disproportionate burden of chronic disease in these regions. Numerous nutritional interventions have been effective in reducing the short-term risk of low birth weight and prematurity. Understanding the potential long-term benefits of such interventions is crucial to inform policy decisions to interrupt the developmental programming cycle and stem the growing epidemics of hypertension and kidney disease worldwide.
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