Term
| Dr Barkers original study? |
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Definition
1989 with southampton Uni colleagues found links between LBW and CHD.
Later found Links to type 2 diabetes, obesity & hypertension as well as permanent changes to bodies structure |
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Term
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Definition
2000 birth records examined then tracked down adults and took measurements.
Had greater risk of diabetes.
Could compare against sibling born from same genes into same environment and found famine meant permanent changes from in utero environment |
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Term
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Definition
23rd Jan 2014 by Yale Medicine - Mice study found mothers with high fat diet altered baby hypothalamus as developing resulting in greater risk of obesty and diabetes.
BUT mice don't process fat in same way so may not apply to pregnant humans. |
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Term
| Factors of a pre pregnancy diet? |
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Definition
Determines egg quality and nutrients available
Folic acid for 12 weeks of pregnancy - ntd
Determines egg environment |
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Term
| Reasons overweight mother may result in HBW baby? |
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Definition
| Overweight mother may eat more refined sugar - simple sugar is quick to placenta - insulin and growth factor released = big baby. |
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Term
| Is a HBW baby more healthy than a LBW? |
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Definition
| Not an indication of health, nutrients may have been missing in energy place or energy may have been inadequate in early pregnancy - Dutch famine example. |
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Term
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Definition
| Baby prioritizes organs it can't share with mother - e.g brain. Will sacrifice kidney development, meaning less nephrons formed due to poor nutritional environment. As adults kidneys have to work harder to manage salt = HBP and risk of hypertension. |
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Term
| Disease risks associated with foetal programming and DOHAD? |
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Definition
| CVD, Type 2 Diabetes, Hypertension and obesity. |
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Term
| What determines the adult outcome? |
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Definition
| It varies depending upon fetal and infant nutrient exposure and which organ is developing. |
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Term
| Factors in the theory of fetal programming? |
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Definition
Genes
Hormonal environment
Placenta nutrients
Maternal BMI, Infection and stresses
Maternal pre pregnancy status
Metabolic behaviour during pregnancy
Famine |
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Term
| Deep south example of epigenetics |
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Definition
| Civil war resulted in famine 100 years ago, despite famine over and similar diet to rest of country there is a greater incidence of associated disease. |
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Term
| Why is nutritional transistion an important factor? |
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Definition
| Fetus programmed adapted to nutritional enviroment it experiences in the womb. Sudden abundance of nutrition versus in utero famine dangerous. |
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Term
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Definition
Increased risk of breast cancer
BUT not if fat as adolescent |
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Term
| HBW has generally a greater risk of what system issues? |
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Definition
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Term
| LBW has a greater risk of issues with what system? |
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Definition
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Term
| Why does the impact of a mothers diet during pregnancy mean potential implications for 100 years? |
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Definition
| Epigenetics - Egg formed in grandmothers pregnancy - gene expression may change which can take many generations of good nutrition to fix. |
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Term
| Why are 'thin' babies not a good thing? |
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Definition
| Muscle developed in last part of pregnancy/1st 6mo. All muscle they'll ever have, can get bigger but not more. High fat/low muscle more risk Type 2 diabetes. |
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Term
| Why must babies not be 'fed up' when born LBW? |
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Definition
| Dr Barker says that there is more likely to be catch up fatness putting the, at risk of CHD. |
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Term
| What are the 3 permanent changes from nutritional deprivation in utero? |
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Definition
Reduced cell numbers
Altered organ structure
Reset hormonal axes. |
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Term
| Who does the idea of foetal programming apply to? |
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Definition
| Healthy babies across all ranges, not just extremes. Not pre term babies as they have separate issues. |
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Term
| LBW babies have an increased risk of what 4 things? |
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Definition
Mortality and morbidity due to infection
increased risk of growth failure
Poor cognitive development
Increased 1st year death |
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Term
| Pros and cons of prospective and retrospective studies as with southampton universty study of 900,000 birthweights. |
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Definition
Retrospective - Results clear but maternal info weak
Prospective - Maternal info strong but results must inferred from markers |
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Term
| How was the dutch famine of 1944 used to reinforce barkers theory? |
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Definition
| Used as an epidemiological study because of the defined time that a previously well nourished population was under famine/rations. Women concieving or pregnant during this time were followed up when food supply was restored. Also comparisons against siblings were used. |
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Term
| Why was the barker theory initially disagreed with? |
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Definition
| Confounding variable through the life course that could contribute to disease, such as environmental factors. Later studies eliminated many of these factors. |
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