LIVING IN THE WOMB AND HEALTH AS CHILDREN AND ADULTS!
THE WOMB - YOUR MOTHER - YOURSELF
Cancer. Heart disease. Obesity, Depression. Scientists can
now trace adult health to the nine months befor birth!!!
by Anne Murphy Paul
WHAT MAKES US THE WAY we are? Why are some people
predisposed to be anxious, overweight or asthmatic? How is it
that some of us are prone to heart attacks, diabetes or high
blood pressure?
There's a list of conventional answers to these questions.
We are the way we are because it's in our genes: the DNA we
inherited at conception. We turn out the way we do because of our
childhood experiences: how we were treated and what we took in,
especially during those crucial first three years. Or our health
and wellbeing stem from the lifestyle choices we make as adults:
what kind of diet we consume, how much exercise we get.
But there's another powerful source of influence you may not
have considered: your life as a fetus. The kind and quantity of
nutrition you received in the womb; the pollutants, drugs and
infections you were exposed to during gestation; your mother's
health, stress level and state of mind while she was pregnant
with you - all these factors shaped you as a baby and a child and
continue to affect you to this day.
This is the provocative contention of a field known as fetal
origins, whose pioneers assert that the nine months of gestation
constitute the most consequential period of our lives, per-
manently influencing the wiring of the brain and the functioning
of organs such as the heart, liver and pancreas. The conditions
we encounter in utero, they claim, shape our susceptibility to
disease, our appetite and metabolism, our intelligence and
temperament. In the literature on the subject, which has exploded
over the past 10 years, you can find references to the fetal
origins of cancer, cardiovascular disease, allergies, asthma,
hypertension, diabetes, obesity, mental illness - even of
conditions associated with old age like arthritis, osteoporosis
and cognitive decline.
The notion of prenatal influence may conjure up frivolous
attempts to enrich the fetus: playing Mozart to a pregnant belly
and the like. In reality, the shaping and molding that goes on in
utero is far more visceral and consequential than that. Much of
what a pregnant woman encounters in her daily life - the air she
breathes, the food and drink she consumes, the chemicals she's
exposed to, even the emotions she feels - is shared in some
fashion with her fetus. The fetus incorporates these offerings
into its own body, makes them part of its flesh and blood.
Often it does something more: it treats these maternal
contributions as information, biological postcards from the world
outside. What a fetus is absorbing in utero is not Mozart's Magic
Flute but the answers to questions much more critical to its
survival: Will it be born into a world of abundance or scarcity?
Will it be safe and protected, or will it face constant dangers
and threats? Will it live a long, fruitful life or a short,
harried one?
Research on fetal origins - also called the developmental
origins of health and disease - is prompting a revolutionary
shift in thinking about where human qualities come from and when
they begin to develop. It's turning pregnancy into a scientific
frontier: the National Institutes of Health embarked last year on
a multidecade study that will examine its subjects before they're
born. It's also altering the perspective of thinkers outside of
biology. The Nobel Prize-winning economist Amartya Sen, for
example, co-authored a paper about the importance of fetal
origins to a population's health and productivity: poor prenatal
experience, he writes, "sows the seeds of ailments that afflict
adults:" And it makes the womb a promising target for prevention,
raising hopes of conquering public-health scourges like obesity
and heart disease through interventions before birth.
[Heart disease was supposed to be all about genetics or adult
lifestyle factors. People scoffed at the idea that it could have
anything to do with intrauterine experience. - David Barker,
Physician and professor at the university of Southhamptom in
England and oregon Health and Science University]
The Origins of Fetal Origins
TWO DECADES AGO, A BRITISH PHYSICIAN named David Barker
noticed an odd correlation on a map: the poorest regions of
England and Wales were the ones with the highest rates of heart
disease. Why would this be, he wondered, when heart disease was
supposed to be a condition of affluence - of sedentary lifestyles
and rich food? He decided to investigate, and after comparing the
adult health of some 15,000 individuals with their birth weight,
he discovered an unexpected link between small birth size - often
an indication of poor
[Adapted from Origins: How the Nine Months Before Birth Shape the
Rest of Our Lives, by Annie Murphy Paul, published in September
by Free Press]
prenatal nutrition - and heart disease in middle age. Faced with
an inadequate food supply, Barker conjectured, the fetus diverts
nutrients to its most important organ, the brain, while skimping
on other parts of its body--a debt that comes due decades later
in the form of a weakened heart.
When he presented his findings to colleagues, he was greeted
with hoots and jeers. "Heart disease was supposed to be all about
genetics or adult lifestyle factors," says Barker, now 72 and a
professor at the University of Southampton in England and at
Oregon Health and Science University. "People scoffed at the idea
that it could have anything to do with intrauterine experience."
Barker persisted, however, amassing evidence of the connection
between birth weight and heart disease in many thousands of
individuals. For years the idea was known as the Barker
hypothesis.
In time his idea began to win converts. Janet Rich-Edwards,
an epidemiologist at Brigham and Women's Hospital in Boston,
deliberately set out to disprove the Barker hypothesis. "I was
convinced that your current risk factors determine your odds of
developing disease," says Rich-Edwards, "not something that
happened when you were a fetus." But, she adds, "there's anothing
like your own data to change your mind." Rich-Edwards analyzed
findings from the Nurses' Health Study, a longrunning
investigation of more than 120,000 RNs. Even when she took
account of the nurses' adult lifestyles and socioeconomic status,
the relationship between low birth weight and cardiovascula-
disease risk remained robust. "Similar studies have been
conducted at least two dozen times since then," she notes. "It's
one of the most solidly replicated findings in the field of
public health."
As a journalist who covers science, I was intrigued when I
first heard about fetal origins. But two years ago, when I began
to delve more deeply into the field, I had a more personal
motivation: I was newly pregnant. If it was true that my actions
over the next nine months would affect my offspring for the rest
of his life, I needed to know more.
Of course, no woman who is pregnant today can escape hearing
the message that what she does affects her fetus. She hears it at
doctor's appointments, sees it in the morning newspaper and in
the pregnancy guidebooks: Do eat this, don't drink that, always
be vigilant - but never stressed. Expectant mothers could be
forgiven for feeling that pregnancy is nothing but a nine-month
slog, full of guilt and devoid of pleasure, and this research
threatened to add to the burden.
But as I began applying what I learned to my own pregnancy,
I developed a very different perspective on fetal origins. The
scientists I met weren't full of dire warnings but of the
excitement of discovery and the hope that their discoveries would
make a positive difference. We're used to hearing about all the
things that can go wrong during pregnancy, but as these
researchers are finding out, it's frequently the intrauterine
environment that makes things go right in later life.
The Power to Change Behavior TAKE, FOR EXAMPLE, THE
PROSTPECT OF maintaining a healthy weight. Americans are heavier
than ever, and their weight gain begins ever earlier in life.
Could it be that a tendency for obesity is being programmed in
the womb? A pair of studies conducted by researchers at Harvard
Medical School suggest that may be the case: the greater a
woman's weight gain during pregnancy, one study found, the higher
the risk that her child would be overweight by age 3. The second
study indicated that this relationship persists into the
offspring's adolescence.
Compared with the teenagers of women who had moderate weight
gain during pregnancy, those of women who had excessive weight
gain were more likely to be obese.
Of course, children could share eating habits or a genetic
predisposition to obesity with their mothers; how can we know the
prenatal environment is to blame? Researchers have compared
children born to obese mothers with their siblings born after the
mothers have had successful antiobesity surgery. The later-born
children inherited similar genes as their older siblings, and
(research shows) practice similar eating habits, but they
experienced different intrauterine environments. In a 2006 study
published in the journal Pediatrics, researchers found that the
children gestated by women postsurgery were 52% less likely to be
obese than siblings born to the same mother when she was still
heavy. A seconds study by the same group, published in 2009,
found that children born after their mothers lost weight had
lower birth weights and were three times less likely to become
severely obese than their older brothers and sisters.
"The bodies of the children who were conceived after their
mothers had weightloss surgery process fats and carbohydrates in
a healthier way than do the bodies of their brothers and sisters
who were conceived at a time when their mothers were still
overweight," says John Kral, a professor of surgery and medicine
at SUNY Downstate Medical Center in New York and co-author of
both papers.
......
[FETAL LINKS]
[Heart Disease]
individuals weighing less at birth have a higher risk of heart
disease later in life than those of normal birth weight, perhaps
in part because an undernourished fetus diverts nutrients to the
brain, giving short shrift to the developing heart.
[Obesity]
Mothers who gain excessive weight during pregnancy tend to have
heavier toddlers; the link may be more than genetic. Kids
conceived after a mother's successful weight-loss surgery were
52% less likely to be obese siblings born while ow she was
overweight
[DIABETES]
A diabetic mother's high blood sugar may disrupt the metabolism
of a fetus, predisposing it to diabetes, as suggested by research
on the Pima Indians, plagued by the world's highest rate of Type
2 diabetes.
..........
To be continued
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