25 May Early Prenatal Events and Infancy Tied To Cardiovascular Events in Adulthood
MedicalResearch.com Interview with:
Dr. Brian Stansfield MD
Children’s Hospital of Georgia and the Medical College of Georgia
MedicalResearch.com: What is the background for this study?
Dr. Stansfield: Since the mid-20th century, we have experimental evidence in animal models and human data demonstrating the influence of maternal nutrition on the offspring – both in the short term and long term. Low birth weight has been connected with higher incidence of cardiometabolic diseases including insulin resistance, coronary artery disease, and hypertension. Interestingly, low birth weight infants grow up to be relatively thin adults compared to their normal or high birth weight counterparts. Conversely, high birth weight infants tend to become heavier adults and obesity is directly linked with the same adult outcomes. So the association of cardiac and metabolic diseases with low birth weight is not linked to adult obesity in general. Thus, speculation as to why extremes of birth weight lead to adult onset cardiometabolic disease suggests different mechanisms and modifying factors.
MedicalResearch.com: What are the main findings?
Dr. Stansfield: The findings of our study shed considerable light on the relationship between birth weight and risk factors for insulin resistance and visceral adiposity. Using magnetic resonance imaging (MRI) to achieve precise measurements of visceral adipose content and biomarkers for insulin resistance, we show that both low and high birth weight are associated with increased visceral adiposity and insulin resistance in a healthy population of adolescents aged 13-17 years. This association persists when we account for several recognized confounders including age, sex, race, activity level, and socioeconomic status. The most interesting finding of our study is that when you account for each adolescent’s current body mass index, a measure of obesity, the relationship between increased visceral fat and insulin resistance and low birth weight is strengthened suggesting that these adolescents had relatively high visceral adipose content despite obesity rates that were similar to their normal birth weight counterparts. On the other hand, correction for adolescent BMI (obesity) reduced the relationship between these metabolic markers and high birth weight infants. Thus, low birth weight infants may develop insulin resistance and increased visceral fat, both significant risk factors for cardiovascular disease and metabolic disease, despite having a relatively normal body shape in adolescents.
MedicalResearch.com: What should readers take away from your report?
Dr. Stansfield: The primary take away from our study and this field of research in general is that cardiovascular disease is not just linked to your family history or diet or exercise, but also to early life events in the womb and in infancy. A healthy pregnancy may be beneficial for your baby in the short and long term.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Dr. Stansfield: A healthy mother and pregnancy imparts a significant advantage to your child in the long run. If mom takes care of herself during pregnancy and delivers a healthy “weight appropriate” infant at term, then she has helped her children avoid particular risk factors associated with cardiometabolic disease. As smoking is the leading cause of poor growth in the womb and low birth weight, it is most important that mothers avoid smoking while pregnant.
MedicalResearch.com: Is there anything else you would like to add?
Dr. Stansfield: While birth weight is clearly associated with later cardiovascular diseases, we do not know how modifiable is this risk factor. In other words, if you are born low or high birth weight, is your cardiovascular risk predetermined or can it be modified by appropriate nutrition in early infancy. Appropriate nutrition in the first months of life may abate or enhance some of this risk, but the degree of modification is not well understood.
MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.
Brian K. Stansfield, Mary Ellen Fain, Jatinder Bhatia, Bernard Gutin, Joshua T. Nguyen, Norman K. Pollock. Nonlinear Relationship between Birth Weight and Visceral Fat in Adolescents. The Journal of Pediatrics, 2016; DOI:10.1016/j.jpeds.2016.04.012
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