Regular readers should by now be quite familiar with the accumulating data suggesting that your risk for future development of obesity, diabetes, and possibly other metabolic diseases, may begin in the womb.
This topic is nicely reviewed in a paper by Marie-Claude Battista and colleagues from the University of Sherbrooke, Quebec, published in Experimental Diabetes Research.
In this paper, the authors not only discuss the relationship between maternal obesity and pregnancy risk (for both mother and child) but also discuss the complex factors that link excess weight to gestational diabetes.
They then extensively review the animal data that shows how intra-uterine epigenetic modifications can lead to a (permanent) metabolic adaptation that substantially increases the risk for obesity and diabetes in the offspring.
Finally, they critically discuss the emerging human data demonstrating the impact of lifestyle and bariatric surgery on both maternal and fetal health and the ability of these interventions to possibly break the vicious circle that perpetuates the transmission of obesity and metabolic conditions to the next generations
As the authors conclude:
“Fetal programming of metabolic function induced by obesity and GDM may have intergenerational effect and thus, perpetuate the burden of such conditions. Mechanisms by which reprogramming of fetal function might occur is directly through maternal metabolic and hormonal effects, epigenetic alterations or impaired placental function. Periconceptional weight loss interventions have demonstrated their ability to reverse the impacts of maternal obesity and GDM on the child and are of great importance for the prevention of future cardiometabolic risks in the offspring, and may thus be the best approach to break the vicious circle of intergenerational propagation of obesity and diabetes.”
They, however also caution that:
“…the nature and the timing of intervention should be carefully considered because it could also by itself induce organ reprogramming and potential long-term effect on the offspring.”
Not an easy topic (and certainly not an easy read) given the complexity of the emerging molecular, metabolic and genetic animal and human data on this issue.
However, certainly a topic that cannot be ignored in any discussion about finding solutions to the obesity epidemic.
Battista MC, Hivert MF, Duval K, & Baillargeon JP (2011). Intergenerational cycle of obesity and diabetes: how can we reduce the burdens of these conditions on the health of future generations? Experimental diabetes research, 2011 PMID: 22110473