Fall Caroline H D
MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK.
Ann Hum Biol. 2011 Jul;38(4):410-28. doi: 10.3109/03014460.2011.592513. Epub 2011 Jun 17.
Research in animals has shown that altering foetal nutrition by under-nourishing or over-nourishing the mother or rendering her diabetic or foetal exposure to glucocorticoids and toxins can programme obesity in later life. The increased adiposity is mediated by permanent changes in appetite, food choices, physical activity and energy metabolism. In humans, increased adiposity has been shown in people who experienced foetal under-nutrition due to maternal famine or over-nutrition due to maternal diabetes. Lower birth weight (a proxy for foetal under-nutrition) is associated with a reduced adult lean mass and increased intra-abdominal fat. Higher birth-weight caused by maternal diabetes is associated with increased total fat mass and obesity in later life. There is growing evidence that maternal obesity, without diabetes, is also a risk factor for obesity in the child, due to foetal over-nutrition effects. Maternal smoking is associated with an increased risk of obesity in the children, although a causal link has not been proven. Other foetal exposures associated with increased adiposity in animals include glucocorticoids and endocrine disruptors.
Reversing the current obesity epidemic will require greater attention to, and better understanding of, these inter-generational (mother-offspring) factors that programme body composition during early development.
动物研究表明，通过使母体营养不足或营养过剩、使其患糖尿病或让胎儿接触糖皮质激素及毒素来改变胎儿营养状况，可导致其成年后肥胖。肥胖程度增加是由食欲、食物选择、身体活动及能量代谢的永久性变化介导的。在人类中，因母亲饥荒导致胎儿营养不足或因母亲患糖尿病导致胎儿营养过剩的人群，肥胖程度均有所增加。较低的出生体重（胎儿营养不足的一个指标）与成人瘦体重降低及腹部脂肪增加有关。母亲患糖尿病导致的较高出生体重与成年后总脂肪量增加及肥胖有关。越来越多的证据表明，母亲肥胖（无糖尿病）由于对胎儿的营养过剩影响，也是儿童肥胖的一个风险因素。母亲吸烟与儿童肥胖风险增加有关，尽管因果关系尚未得到证实。在动物中，与肥胖程度增加有关的其他胎儿暴露因素包括糖皮质激素和内分泌干扰物。
扭转当前的肥胖流行趋势需要更加关注并更好地理解这些在早期发育过程中影响身体组成的代际（母亲 - 后代）因素。
