Early Origins of Cardiometabolic Disease
Authors: Kumaran Kalyanaraman, Clive Osmond, Caroline Fall
Low birth and infant weight, followed by rapid weight gain in later childhood, are associated with an increased risk of cardiovascular disease mortality, morbidity, and risk factors, including high blood pressure, diabetes, and metabolic syndrome. The developmental origins of health and disease (DOHaD) hypothesis suggests that early undernutrition permanently programs the body’s structure and metabolism and leaves an increased vulnerability to the adverse effects of excess nutrition in later life. High birth weight has also been associated with an increased risk of diabetes. The DOHaD concepts offer a primordial preventive strategy to reduce the risk in future generations by improving development in early life. Some evidence suggests that early life interventions may be both effective and cost-effective, but interventions focused solely on increasing birth weight may not be appropriate. Interventions to reduce the burden of low birth weight; promotion of a holistic approach before and during pregnancy to improve the health of young women and mothers; and further research on understanding optimum growth patterns during fetal life, infancy, and childhood to target interventions are recommended.