SLIDE 1
Developmental Origins of Health and Disease BASELINE Parent - - PowerPoint PPT Presentation
Developmental Origins of Health and Disease BASELINE Parent - - PowerPoint PPT Presentation
Developmental Origins of Health and Disease BASELINE Parent Information Evening October 16th 2012 Dr Deirdre Murray Cork BASELINE Birth Cohort Study The most exciting phrase to hear in science, the one that heralds the most discoveries, is
SLIDE 2
SLIDE 3
“The most exciting phrase to hear in science, the one that heralds the most discoveries, is not "Eureka!" (I found it!) but 'That's funny...”
- Isaac Asimov
Prof David Barker, Southampton University
SLIDE 4
Increasing wealth and nutrition associated with increasing rates of heart disease and obesity Low birth weight associated with highest rates
SLIDE 5
Dutch Famine 1944
SLIDE 6
Fetal growth High blood pressure High cholesterol Diabetes Polycystic ovaries Kidney disease
SLIDE 7
Maternal genes & Environment Maternal body composition nutritional or stress hormone levels Survival In early life Adult lifestyle Risk factors
- Eg. obesity
Adult disease Altered structure/function
- f insulin-sensitive
Target tissues Altered structure And function of the endocrine pancreas
Theories
Reduced nephrons Hypertension ESRF
SLIDE 8
Obesity, hypertension, Cardiovascular disease, Type 2 diabetes Metabolic syndrome Polycystic ovaries Hypercholesterolaemia End stage renal failure Low birth weight Genetic predisposition Diet Exercise Stress
SLIDE 9
National longitudinal survey 9 year old children in Ireland in 2009 19% overweight, 7% obese
SLIDE 10
Obesity in U.S. 9% at 3 years 30% at 5 years
SLIDE 11
Feeding Growth Body fat % Eczema,TEWL Food allergy General health Childhood illness Developmental screening
Intrauterine growth restriction Detailed neurodevelopment assessment BP, Insulin resistance, 25-OH-D3
Skin prick testing
2500
Birth 2m 6m 12m 24m Biobanking TEWL Body fat % Anthropometry Neonatal course
5years
SLIDE 12
The normal term newborn
Mean n=996
- Std. Dev
G.A. at delivery (w) 39.75 1.15 Birthweight 3509.10 469.4 Head circumference 34.8 1.4 Length 50.4 2.0 Age (days) 1.83 .99 % body fat 11.18 5.13 Fat mass, kg .378 .172 Fat free mass, kg 2.951 .359 Fatlengthratio g/cm 7.45 3.27
SLIDE 13
Gestational Age Males Females P-Value 36-37+6 wk 8.8 (3.2) 8.9 (3.8) 0.97 38-39+6 wk 9.8 (3.9) 11.1 (3.9) 0.01 40-41+6 wk 10 (3.9) 12.5 (4.4) <0.001 Total 9.8 (3.9) 11.9 (4.3) <0.001
Females have a greater proportion of body fat at each gestation Body fat is disproportionately accumulated relative to lean body mass
at increasing term gestation
SLIDE 14
Results: Centile Chart Generated
SLIDE 15
- Females have more body fat than Males
- Despite males having a greater birthweight
- %Body fat increases with increasing gestation
Hawkes CP, Pediatrics Sept 2011
SLIDE 16
Body Composition in small for gestational age babies
August 2008 to February 2011 (n=1335) Body Fat composition, as measured by air displacement plethysmography was available for 66.7% (n=890) SGA babies 11.1% (n=148)
SLIDE 17
Distribution of Mean % Body Fat across the Customised Birthweight Quartiles n=890
SLIDE 18
Mean % Body Fat across the Gestational Ages
2 4 6 8 10 12 14
22-35+6 36-37+6 38-39+6 40-42+6 Mean % Body Fat Gestational Age
FGR Non FGR Total
SGA AGA Total
SLIDE 19
Conclusion
- Altered body composition in small infants (< 10th BW
centile)
- Normal increase in %BF with gestational age does not
- ccur in the SGA baby
SLIDE 20
Are the effects of growth restriction related to body fat at birth? Can we help to predict adult health?
SLIDE 21
Factors influencing early growth
Maternal nutrition Baby’s nutrition Socioeconomic factors Blood pressure Cholesterol Insulin resistance Growth
SLIDE 22