2.
Metabolic programming
NCDs, including obesity, type II diabetes and cardiovascular diseases, have reached epidemic
proportions worldwide and have become the principal cause of mortality and disability. A poor,
unbalanced maternal diet and micronutrient deficiencies may result in undernutrition or
overnutrition of the unborn child. The concept of “nutrition” includes the BMI, the body build,
the food consumed and the individual’s clinical status, reflecting whether the body is supplied
with the nutrients required for its needs.
The fetus modifies its metabolism to support its body functions. These changes may be
irreversible and possibly entail altered metabolic homeostasis and an improperly functioning
endocrine system after birth, which increases the child’s susceptibility to NCDs in later life. Lack
of balance between the physiological needs of the body and the actual energy and nutrient
uptake before, during and immediately after pregnancy may accelerate the child’s early
development, which in turn can increase the child’s risks for obesity and NCDs. Evidence
suggests that the obesity epidemic might be attributable to inadequate nutrition of unborn
children during the antenatal
period (undernutrition or overnutrition), followed by a poor,
unbalanced diet high in fat, salt and sugar later in life.
Fig. 4 illustrates the metabolic factors that are altered in metabolic programming and the
possible triggering mechanisms.
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