1 - NICU, Hospital Dona Estefânia, Centro Hospitlar Universitário de Lisboa Central
2 - NOVA Medical School, Universidade Nova de Lisboa, Portugal
- Annals of Nutrition and Metabolism 2022 (suppl. 4):38 [Abstract]. doi: 10.1159/000526958.
Obesity is a current, practically universal public health problem. The ‘first 1000 days of life, between conception and 24 postnatal months, is a sensitive period for the development of mechanisms that predispose to obesity programming. This review focuses on the periods involving fetal life and the first 12 postnatal months. Human and animal studies revealed that both fetal undernutrition and overnutrition can predispose to obesity through different mechanisms. Among those underlying fetal undernutrition, epigenetics predominate, which represents the interaction with genotype variation at an early stage of development characterized by plasticity, altering the future ability to interact with the environment.
Other pathways involved in fetal undernutrition include permanent structural changes to key organs and tissues with disruption of cellular proliferation and differentiation, long-lasting dysregulation of orexigenic and anorexigenic peptides increasing postnatal appetite, long-lasting dysregulation of endocrine expression including insulin resistance, and placental dysregulation, particularly the reduction of 11β-hydroxysteroid dehydrogenase-2 activity and exposure of fetal tissues to high glucocorticoids levels.
In the case of maternal overnutrition, independent factors predisposing to offspring obesity and excess adiposity include prepregnancy obesity, excessive gestational weight gain, and gestational diabetes, some of the pathways mediated by oxidative stress and epigenetic chromatin remodelling.
Palavras-Chave: Early programming; obesity.