Lipid Metabolism and Obesity in Early Life: Drivers of Chronic Lung Disease From Development to Adulthood

Overweight and obesity have become a severe global pandemic with growing social and health policy implications. Alarmingly, this not only affects adults, but also children and adolescents. Accumulating evidence in humans as well as in experimental studies indicates that an obesogenic environment across life span, ranging from in utero to adulthood, is associated with lung injury and chronic lung disease. Obesity is intimately linked to an excessive calorie intake as well as to an accumulation of lipids and a dysregulation of lipid metabolism in adipose tissue, but also within cells of many other organs. In the present review, we focus on the impact of lipids and lipid derivatives on lung morphogenic programming, normal and aberrant lung homeostasis as well as initiation and progression of chronic lung diseases. A specific emphasis was placed on alveolar surfactant and sphingolipids, and their functional contribution to molecular and cellular processes in the developing and mature lung. Finally, this review also discusses briefly the hitherto only little explored preventive and therapeutic possibilities of lipids and dietary adaptations, and thus the modulation of ingested lipids on lung health. Overweight and obesity, affecting all ages, contribute to lung injury and chronic lung disease. This review explores how lipids and their derivatives influence lung development, function, and disease progression-including surfactant and sphingolipids-and considers the underexplored potential of dietary lipid modulation as a preventive and therapeutic strategy for lung health.