The thrifty phenotype: An adaptation in growth or metabolism?

Shared genetic architecture links energy metabolism, behavior and starvation resistance along a power-endurance axis

Shared developmental, physiological, and molecular mechanisms can generate strong genetic covariances across suites of traits, constraining genetic variability, and evolvability to certain axes in multivariate trait space ("variational modules" or "syndromes"). Such trait suites will not only respond jointly to selection; they will also covary across populations that diverged from one another by genetic drift. We report evidence for such a genetically correlated trait suite that links traits related to energy metabolism along a "power-endurance" axis in Drosophila melanogaster. The "power" pole of the axis is characterized by high potential for energy generation and expenditure-high expression of glycolysis and TCA cycle genes, high abundance of mitochondria, and high spontaneous locomotor activity. The opposite "endurance" pole is characterized by high triglyceride (fat) reserves, locomotor endurance, and starvation resistance (and low values of traits associated with the "power" pole). This trait suite also aligns with the first principal component of metabolome; the "power" direction is characterized by low levels of trehalose (blood sugar) and high levels of some amino acids and their derivatives, including creatine, a compound known to facilitate energy production in muscles. Our evidence comes from six replicate "Selected" populations adapted to a nutrient-poor larval diet regime during 250 generations of experimental evolution and six "Control" populations evolved in parallel on a standard diet regime. We found that, within each of these experimental evolutionary regimes, the above traits strongly covaried along this "power-endurance" axis across replicate populations which diversified by drift, indicating a shared genetic architecture. The two evolutionary regimes also drove divergence along this axis, with Selected populations on average displaced towards the "power" direction compared to Controls. Aspects of this "power-endurance" axis resemble the "pace of life" syndrome and the "thrifty phenotype"; it may have evolved as part of a coordinated organismal response to nutritional conditions.

Beyond Traditional Body Composition Metrics: Load-Capacity Indices Emerge as Predictors of Cardiometabolic Outcomes-A Systematic Review and Meta-Analysis

The adaptive and independent interrelationships between different body composition components have been identified as crucial determinants of disease risk. On the basis of this concept, the load-capacity model of body composition, which utilizes measurements obtained through nonanthropometric techniques such as dual-energy X-ray absorptiometry, was proposed. This model is typically operationalized as the ratio of metabolic load (adipose mass) to metabolic capacity (lean mass). In recent years, a series of load-capacity indices (LCIs) have been utilized to identify abnormal body composition phenotypes such as sarcopenic obesity (SO) and to predict the risk of metabolic, cardiovascular, and cognitive disorders. In this review, we comprehensively review the characteristics of different LCIs used in previous studies, with a specific focus on their applications, especially in identifying SO and predicting cardiometabolic outcomes. A systematic literature search was performed using PubMed, MEDLINE, PsycINFO, Embase, and the Cochrane Library. Two meta-analyses were conducted to 1) estimate the overall prevalence of SO mapped by LCIs, and 2) assess the association of LCIs with cardiometabolic outcomes. A total of 48 studies (all observational) were included, comprising 22 different LCIs. Ten studies were included in the meta-analysis of SO prevalence, yielding a pooled prevalence of 14.5% [95% confidence interval (CI): 9.4%, 21.6%]. Seventeen studies were included in the meta-analysis of the association between LCIs and adverse cardiometabolic outcomes, which showed a significant association between higher LCI values and increased risk (odds ratio = 2.22; 95% CI: 1.81, 2.72) of cardiometabolic diseases (e.g. diabetes and metabolic syndrome). These findings suggest that the load-capacity model of body composition could be particularly useful in the identification of SO cases and prediction of cardiometabolic risk. Future longitudinal studies are needed to validate the association of LCIs with chronic cardiometabolic and neurodegenerative diseases. This systematic review and meta-analysis has been registered with PROSPERO (CRD42024457750).

Prevalence and sociodemographic factors associated with double burden of malnutrition among children under 5: a cross-sectional analysis of NFHS-4 data in India

Background

The double burden of malnutrition (DBM), characterised by the coexistence of undernutrition and overnutrition, poses a significant public health challenge, particularly in low- and middle-income countries. India, being one of these countries, faces a rising burden of malnutrition, with persistently high levels of stunting and a significant increase in overweight and obesity among children under 5 years old.

Aim

To estimate the prevalence of DBM and associated sociodemographic factors among children aged 0-5 years in India, using data from the National Family Health Survey-4 (NFHS-4).

Materials and methods

A secondary data analysis of the NFHS-4 (2015-2016) a nationally representative cross-sectional data was conducted. The study population consisted of 57 951 children aged 0-5 years, and anthropometric data were extracted from the NFHS-4 India database. Child growth indicators, including stunting, overweight, obesity and DBM were analysed using internationally recognised WHO Child Growth Standards. Descriptive statistics, graphical representations and the χ2 test of significance were employed to explore the relationships between DBM and various factors.

Results

The analysis of data from the NFHS-4 for India revealed that the prevalence of the DBM among children aged 0-5 years was 2.3% (95% CI 2.2% to 2.5%).

Conclusion

While the prevalence of DBM among children under 5 years of age in India is relatively low at 2.3%, the implications of this issue are far-reaching and enduring. Despite appearing modest, addressing DBM requires sustained attention and comprehensive strategies. Extensive research with larger samples is essential for understanding complex challenges.

Supplementation with a Whey Protein Concentrate Enriched in Bovine Milk Exosomes Improves Longitudinal Growth and Supports Bone Health During Catch-Up Growth in Rats

BACKGROUND

Undernutrition impairs linear growth while restoration of nutritional provisions leads to accelerated growth patterns. However, the composition of the nutrition provided is key to facilitating effective catch-up growth without compromising bone quantity, quality, and long-term health.

METHODS

We evaluated the role of a whey protein concentrate enriched in bovine milk exosomes (BMEs) in modulating the proliferative properties of human chondrocytes in vitro and studied how these effects might impact bone quantity and quality measured as longitudinal tibia growth, bone mineral content (BMC) and density (BMD), and trabecular micro-CT parameters in stunted rats during catch-up growth.

RESULTS

BMEs promoted proliferation in C28/I2 human chondrocytes mediated by mTOR-Akt signaling. In a stunting rat model, two-week supplementation with BMEs during refeeding was associated with improved tibia BMD, trabecular microstructure (trabecular number (Tb. N.) and space (Tb. Sp.)), and a more active growth plate (higher volume, surface, and thickness) compared to non-supplemented stunted rats. Positive effects on physis translated to significantly longer tibias without compromising bone quality when extending the refeeding period for another two weeks.

CONCLUSIONS

Overall, BME supplementation positively contributed to longitudinal bone growth and improved bone quantity and quality during catch-up growth. These findings might be relevant for improving diets aimed at addressing the nutritional needs of children undergoing undernutrition during early life.

Evaluating the Concept of Brain Sparing in a High Income Setting, Using Historical Records of Maternal Influenza or Syphilis Infection

INTRODUCTION

In the context of adverse in utero environments, the fetal brain might be preserved at the expense of other tissues. This trade-off, brain sparing, has not been studied in the context of maternal infection. We investigated cases of maternal syphilis in the early 20th century and influenza during the 1918-1920 pandemic, in the Swiss city of Lausanne, a relatively high-income setting. We tested the brain sparing hypothesis, that head circumference is protected at the expense of birth weight.

METHODS

A total of 8530 individual birth records from 1911 to 1922 from the University Maternity Hospital of Lausanne were used. We fitted generalized linear and additive linear models to explain how neonatal size varies under disease exposure.

RESULTS

Influenza reduced head circumference and birth weight among livebirths similarly, by -0.11 and -0.14 standard deviation (SD) units respectively. Conversely, for syphilis-exposed infants, head circumference was affected more than birth weight (-0.61 SD vs. -0.46 SD). Stillborn infants exposed to syphilis experienced a much greater reduction in head circumference (-1.92 SD) than liveborn infants. After adjustment for gestational age, these findings persisted in the case of influenza, but the effects of syphilis were reduced. Furthermore, half of syphilis-exposed infants were born before term, suggesting that lower infant size was partly mediated by shorter gestation. Nevertheless, head circumference among stillbirths exposed to syphilis was still substantially reduced, even after adjustment for gestational age (-1.26 SD).

CONCLUSION

Our findings do not support the brain sparing hypothesis. Moreover, the substantial reduction in head circumference among syphilis-exposed fetuses might help explain why a quarter of them were stillborn.

Seasonal changes in body composition in children from Maya agriculturalists in central Yucatán, Mexico

INTRODUCTION

Development policies have aimed to substitute subsistence agriculture for cash crops or other cash generating activities to encourage local farmers to depend on store-bought groceries available year-round instead of seasonal subsistence crops. In this paper, we test the hypothesis that increased dependence on store bought foods has decreased seasonal changes in nutritional status and fat mass in Maya Children from Yucatan, Mexico.

METHODS

Weight for age (W/A), body mass index (BMI), and tricipital Skinfold z scores in children under the age of 10 years from 14 Maya rural towns with different degrees of development were compared longitudinally between scarcity and abundance seasons using a repeated measures analysis of variance. Height for age (H/A) z scores were also estimated.

RESULTS

Origin of food consumed corresponded to the town's degree of development. Nutritional status (W/Az) and adiposity, BMI, and tricipital z scores were significantly lower during the scarcity season in every community. W/Az, tricipital skinfold z, and H/Az scores were significantly higher in developed than in traditional towns, yet in both types of town W/Az and H/Az scores were below the WHO standard mean. Tricipital skinfold z score was only below the WHO standard amongst traditional towns during the scarcity season.

CONCLUSIONS

Increased dependence on store foods failed to eliminate significant losses in body fat during the scarcity season. This failure may be affecting linear growth and promoting a thrifty phenotype that is seen in short and stocky individuals with a tendency to accumulate fat during abundance seasons.

Association between preterm infant body composition in the first 3 months of life and preschool age: a cohort study

Compared with full-term infants, preterm infants have fat-free mass deficit in the first months of life, which increases the risk of metabolic diseases in the future. In this cohort of children born under 32-week gestational age or less than 1500 g, we aimed to evaluate the associations of body composition at term equivalent age and in the first 3 months of life with fat-free mass and fat mass percentage at 4 to 7 years of life. Body composition assessments by air displacement plethysmography and anthropometry were performed at term, at 3 months of corrected age, and at 4 to 7 years of age. Multiple linear regression analysis was used to observe the associations between body composition at these ages. At term, fat mass percentage showed a negative association and fat-free mass a positive association with fat-free mass at 4 to 7 years. The fat-free mass at 3 months and the gain in fat-free mass between term and 3 months showed positive associations with fat-free mass at 4 to 7 years.   Conclusion: Body composition at preschool age is associated with fat-free mass in the first 3 months of life, a sensitive period for the risk of metabolic diseases. What is Known: • Preterm infants have a deficit in fat-free mass and high adiposity at term equivalent age compared to full-term infants. • Fat-free mass reflects metabolic capacity throughout life and therefore is considered a protective factor against the risk of metabolic syndrome. What is New: •Fat-free mass gain in the first 3 months of corrected age is associated with fat-free mass at preschool and school ages. •The first 3 months of life is a sensitive period to the risk of metabolic diseases.

Birth weight and nutritional status in school-age children from Boane city, Mozambique

BACKGROUND

Birth weight is considered an important marker of inadequate maternal nutrition, and it is a critical indicator of the newborn's health and development.

OBJECTIVE

This study evaluated the influence of low birth weight (LBW) on body composition in 7-10-year-old school children from Boane City-Mozambique.

METHODS

A total of 220 children (female = 122 and male = 98) were divided into two groups according to their birth weight (LBW, n = 41; and normal birth weight, NBW, n = 179). Anthropometric indicators of nutritional status were analyzed by the indices weight-for-age, height-for-age, BMI-for-age, and weight-for-height.

RESULTS

LBW children showed reduced skinfolds, and weight-for-height when compared to NBW children. Birth weight was positively associated with all anthropometric variables, except for BMI, which was not associated with any other variable. The r2 value ranged from .09 (weight-for-age) to .72 (height-for-age). For body composition variables, older children had higher fat mass (β = .26; 95% CI = 0.05-0.48) and fat-free mass (β = 1.10; 95% CI = 0.71-1.48), and boys had lower fat percentage (β = -3.49; 95% CI = -4.35 to -2.65) and fat mass (β = -.92; 95% CI = -1.31 to -0.55) than girls. Birth weight was also positively associated with fat-free mass.

CONCLUSION

LBW seems to influence some growth indicators of children living in Boane, however, current environmental factors seem to weaken this association. Our results suggest that public policies involving healthy nutrition and physical activity can reverse the effects of low weight in children from Boane.

Summatory Effects of Anaerobic Exercise and a 'Westernized Athletic Diet' on Gut Dysbiosis and Chronic Low-Grade Metabolic Acidosis

Anaerobic exercise decreases systemic pH and increases metabolic acidosis in athletes, altering the acid-base homeostasis. In addition, nutritional recommendations advising athletes to intake higher amounts of proteins and simple carbohydrates (including from sport functional supplements) could be detrimental to restoring acid-base balance. Here, this specific nutrition could be classified as an acidic diet and defined as 'Westernized athletic nutrition'. The maintenance of a chronic physiological state of low-grade metabolic acidosis produces detrimental effects on systemic health, physical performance, and inflammation. Therefore, nutrition must be capable of compensating for systemic acidosis from anaerobic exercise. The healthy gut microbiota can contribute to improving health and physical performance in athletes and, specifically, decrease the systemic acidic load through the conversion of lactate from systemic circulation to short-chain fatty acids in the proximal colon. On the contrary, microbial dysbiosis results in negative consequences for host health and physical performance because it results in a greater accumulation of systemic lactate, hydrogen ions, carbon dioxide, bacterial endotoxins, bioamines, and immunogenic compounds that are transported through the epithelia into the blood circulation. In conclusion, the systemic metabolic acidosis resulting from anaerobic exercise can be aggravated through an acidic diet, promoting chronic, low-grade metabolic acidosis in athletes. The individuality of athletic training and nutrition must take into consideration the acid-base homeostasis to modulate microbiota and adaptive physiological responses.

The metabolic load-capacity model and cardiometabolic health in children and youth with obesity

BACKGROUND

The metabolic load-capacity index (LCI), which represents the ratio of adipose to skeletal muscle tissue-containing compartments, is potentially associated with cardiometabolic diseases.

OBJECTIVES

To examine the associations between the LCI and cardiometabolic risk factors in children and youth with obesity.

METHODS

This is a cross-sectional study including 10-18 years-old participants with a BMI of ≥95th . LCI by air-displacement plethysmography (ADP) was calculated as fat mass divided by fat-free mass, and LCI by ultrasound (US) as subcutaneous adipose tissue divided by skeletal muscle thickness. Sex-specific medians stratified participants into high versus low LCI. Single (inflammation, insulin resistance, dyslipidemia and hypertension) and clustered cardiometabolic risk factors were evaluated. Linear and logistic regression models tested the associations between these variables, adjusted for sexual maturation.

RESULTS

Thirty-nine participants (43.6% males; 59% mid-late puberty) aged 12.5 (IQR: 11.1-13.5) years were included. LCI by ADP was positively associated with markers of inflammation and dyslipidemia; having a higher LCI predicted dyslipidemia in logistic regression. Similarly, LCI by US was positively associated with markers of dyslipidemia and blood pressure. In mid-late pubertal participants, LCI by US was positively associated with markers of insulin resistance and inflammation.

CONCLUSIONS

Participants with unfavourable cardiometabolic profile had higher LCI, suggesting its potential use for predicting and monitoring cardiometabolic health in clinical settings.

Trends in social determinants of inequality in child undernutrition from the Ethiopian Demographic and Health Surveys, 2005-2016

BACKGROUND

While child undernutrition has been eliminated in some middle-income countries, it remains highly prevalent in sub-Sahara African (SSA) and South Asian regions, and is disproportionately concentrated among the poor. In this study, we estimated trends in child undernutrition by social determinants and related risks from wealth inequality in Ethiopia, from 2005 to 2016.

METHOD

We analyzed data from three consecutive surveys (2005, 2011, and 2016) from the Ethiopian Demographic and Health Survey. First, we estimated trends in the prevalence of childhood undernutrition variables (stunting, underweight, and wasting) and social determinants (household wealth status, education level, place of residence, and administrative regions). Then we assessed evidence of undernutrition by wealth-related inequality with concentration curves (visual) and concentration indeces (quantitative). A multilevel mixed-effect Poisson regression model was used to identify predictors of undernutrition variables expressed as covariate-adjusted rate ratios, with 95% confidence intervals (RRs, 95%CI).

RESULT

A total of 23,934 mother-child pairs were obtained from the three surveys. The average prevalence decreased by 12.4 percentage points for stunting (from 50.8 to 38.4%, P<0.01), 9.5 percentage points for underweight (33.2% to23.7%, P<0.01), and 2.1 percentage points for wasting (12.2% to10.1%, P<0.01). There was persistent and statistically evidence of wealth inequality in stunting, underweight, and wasting (concentration indeces of -0.2 to -0.04, all P values <0.05). Stunting, underweight, and wasting variables were associated with male sex of the child (RR 0.94, 0.95, 0.85, all P-values <0.01) recent diarrhea (RR 1.18, 1.27, 1.37, all P-values <0.01), secondary education status of the mother (RR 0.66, 0.57, 0.61, all P-values < 0.057), increasing wealth index (richest) (RR 0.73, 0.70, 0.50, all P-values < 0.05), and having no toilet facility (RR 1.16, 1.22, 1.18, all P-values < 0.05).

CONCLUSION

Despite the decreased burden of stunting and underweight, the prevalence of wasting remained relatively unchanged in Ethiopia from 2005 to 2016. Moreover, wealth-related inequality in child undernutrition increased for most of the child undernutrition indicators during this period. Social determinants of child undernutrition warrant urgent implementation of strategies to reduce their health impacts in SSA.

Association between age at menarche and cardiometabolic risk among Samoan adults

OBJECTIVES

Recent studies suggest that early menarche may increase cardiometabolic morbidity and mortality. Yet few studies have examined this association in the Pacific Islands, where obesity prevalence is among the highest globally. We sought to examine associations between age at menarche and cardiometabolic risk in Samoa.

METHODS

Participants were from the Soifua Manuia study (n = 285, age 32-72 years) conducted in Samoa from 2017 to 2019. Logistic regressions were conducted to estimate odds of obesity, hypertension, diabetes, dyslipidemia, and metabolic syndrome per one-year increase in age at menarche. Linear regressions were conducted to examine associations between age at menarche and continuous measures of adiposity, blood pressure, insulin resistance, and serum lipids.

RESULTS

Median age at menarche was 14 years (IQR = 2). After controlling for relevant covariates, each one-year increase in age at menarche was associated with a 15% decrease (OR = 0.85, 95% CI: 0.72-1.01, p = .067) in odds of hypertension, but a 21% increase (OR = 1.21, 95% CI: 1.01-1.45, p = .044) in odds of diabetes and 18% increase (OR = 1.18, 95% CI: 0.98-1.42, p = .081) in odds of high total cholesterol. Each additional year in age at menarche was associated with a 1.60 ± 0.52 kg (p = .002) decrease in lean mass and 1.56 ± 0.51 kg (p = .003) decrease in fat-free mass.

CONCLUSIONS

Associations between age at menarche and cardiometabolic risk may be population-specific and are likely influenced by both current and historical nutritional and epidemiological contexts. Prospective studies are needed to clarify the role of childhood adiposity and other early life exposures on age at menarche and subsequent cardiometabolic risk.

Physical and social activities constraint and its effects on Body Mass Index of former Neonatal Intensive Care children

OBJECTIVE

It is reported weight gain in children due to the confinement measures during the Covid-19 pandemic. We aimed to describe the effect of these measures on the nutritional status of former Neonatal Intensive Care Unit children.

METHODS

Cross-sectional study, including former Neonatal Intensive Care Unit children. The outcome was the Body mass index (BMI).

RESULTS

We enrolled 126 children (74.6 % preterm; 31 % small-for-gestational-age). Weight excess was greater in the youngest group (≤5 years: 33.8 %; >5 years: 15.2 %). Prematurity was associated with weight excess in both groups (≤5 years: p value 0.006; >5 years: p value 0.046; Pearson test). Mealtime changes, lack of physical activity, socioeconomic factors and the perinatal morbidities significantly influenced the mean BMI. Birth length Z score less than -1.28 was negatively associated with BMI, while gestational age at birth presented a positive association with BMI (linear regression model).

CONCLUSIONS

The BMI increase due to the confinement measures associated with the gestational age at birth and in those born with intrauterine growth restriction is a matter of concern, as it might indicate a risk for future obesity.

Developmental stress does not induce genome-wide DNA methylation changes in wild great tit (Parus major) nestlings

The environment experienced during early life is a crucial factor in the life of many organisms. This early life environment has been shown to have profound effects on morphology, physiology and fitness. However, the molecular mechanisms that mediate these effects are largely unknown, even though they are essential for our understanding of the processes that induce phenotypic variation in natural populations. DNA methylation is an epigenetic mechanism that has been suggested to explain such environmentally induced phenotypic changes early in life. To investigate whether DNA methylation changes are associated with experimentally induced early developmental effects, we cross-fostered great tit (Parus major) nestlings and manipulated their brood sizes in a natural study population. We assessed experimental brood size effects on pre-fledging biometry and behaviour. We linked this to genome-wide DNA methylation levels of CpG sites in erythrocyte DNA, using 122 individuals and an improved epiGBS2 laboratory protocol. Brood enlargement caused developmental stress and negatively affected nestling condition, predominantly during the second half of the breeding season, when conditions are harsher. Brood enlargement, however, affected nestling DNA methylation in only one CpG site and only if the hatch date was taken into account. In conclusion, this study shows that nutritional stress in enlarged broods does not associate with direct effects on genome-wide DNA methylation. Future studies should assess whether genome-wide DNA methylation variation may arise later in life as a consequence of phenotypic changes during early development.

The energetics of childhood: Current knowledge and insights into human variation, evolution, and health

How organisms capture and ultimately use metabolic energy-a limiting resource of life-has profound implications for understanding evolutionary legacies and current patterns of phenotypic variation, adaptation, and health. Energetics research among humans has a rich history in biological anthropology and beyond. The energetics of childhood, however, remains relatively underexplored. This shortcoming is notable given the accepted importance of childhood in the evolution of the unique human life history pattern as well as the known sensitivity of childhood development to local environments and lived experiences. In this review, I have three objectives: (1) To overview current knowledge regarding how children acquire and use energy, highlighting work among diverse human populations and pointing to recent advances and remaining areas of uncertainty; (2) To discuss key applications of this knowledge for understanding human variation, evolution, and health; (3) To recommend future avenues for research. A growing body of evidence supports a model of trade-offs and constraint in childhood energy expenditure. This model, combined with advancements on topics such as the energetics of immune activity, the brain, and the gut, provides insights into the evolution of extended human subadulthood and the nature of variation in childhood development, lifetime phenotype, and health.

Double burden of malnutrition as a risk factor for overweight and obesity

OBJECTIVE

To assess the longitudinal effect of double burden of malnutrition (DBM) on the risk of developing child and adolescent overweight or obesity.

METHODS

Analysis of the Peruvian Young Lives Study, younger cohort: baseline (2002) and 4 follow-ups (2006-2007, 2009-2010, 2013-2014, and 2016-2017). Outcomes were the incidence of overweight and obesity as defined by the World Health Organization standards. The exposure comprised a variable with 4 categories: non-stunted child with a non-overweight mother (reference group), non-stunted child with an overweight mother, stunted child with a non-overweight mother, and stunted child with an overweight mother (i.e., DBM). Poisson regression models were built to assess the association of interest, and relative risks (RR) and 95%CI were reported.

RESULTS

Data from 2,034 children; 50.0% were girls and the mean age was 12.0 (3.6) months at baseline. Non-stunted children with an overweight mother had greater risk (RR = 1.64; 95%CI: 1.35-1.99) of developing overweight, compared with the risk for stunted children with a non-overweight mother (RR = 1.38; 95%CI: 1.10-1.72), and for those with DBM (RR = 1.28; 95%CI: 1.02-1.61). When compared with the reference group, obesity risk was greater among non-stunted children with an overweight mother (RR = 2.33; 95%CI: 1.68-3.22), greater among stunted children with a non-overweight mother (RR = 2.59; 95%CI: 1.75-3.84), and greater among those with DBM (RR = 2.14; 95%CI: 1.39-3.28).

CONCLUSIONS

DBM is a risk factor for childhood overweight and obesity in Peru. Dual-duty policies tackling both undernutrition in children and overweight in mothers are needed to reduce DBM and its future effects in Peru.

Body composition at 4 to 7 years of age in children born <32 weeks gestational age or 1500 g: A cohort study

BACKGROUND

Small for gestational age preterm infants show differences in body composition when compared to those appropriate for gestational age at term, which have consequences on metabolism.

AIM

To compare growth and body composition of children born small and appropriate for gestational age between 4 and 7 years.

METHOD

A Cohort of small and appropriate for gestational age infants <32 weeks or 1500 g were followed at term and 3 months corrected ages and at 4 to 7 years. Body composition assessment by air displacement plethysmography and anthropometry were performed at all moments. Differences between the two groups were assessed using t-student and Chi-square tests.

RESULTS

Ninety-four infants were included at term (26 small and 68 appropriate for gestational age); 88 at 3 months (24 small and 64 appropriate for gestational age) and 47 between 4 and 7 years (11 small and 36 appropriate for gestational age). At term, small for gestational age infants had lower fat-free mass, fat mass, weight and length compared with those appropriate for gestational age (p < 0.001). At 3 months, fat-free mass (grams) remained lower in small for gestational age group (p < 0.001). Between 4 and 7 years, body composition and anthropometry were similar between the groups.

CONCLUSION

Between 4 and 7 years, children born small and appropriate for gestational age had similar body composition. New long-term longitudinal studies are necessary to understand the influence of fat-free mass and fat mass in the first months of age on body composition throughout life.

The hormetic and hermetic role of IL-6

Interleukin-6 is a pleiotropic cytokine regulating different tissues and organs in diverse and sometimes discrepant ways. The dual and sometime hermetic nature of IL-6 action has been highlighted in several contexts and can be explained by the concept of hormesis, in which beneficial or toxic effects can be induced by the same molecule depending on the intensity, persistence, and nature of the stimulation. According with hormesis, a low and/or controlled IL-6 release is associated with anti-inflammatory, antioxidant, and pro-myogenic actions, whereas increased systemic levels of IL-6 can induce pro-inflammatory, pro-oxidant and pro-fibrotic responses. However, many aspects regarding the multifaceted action of IL-6 and the complex nature of its signal transduction remains to be fully elucidated. In this review we collect mechanistic insight into the molecular networks contributing to normal or pathologic changes during advancing age and in chronic diseases. We point out the involvement of IL-6 deregulation in aging-related diseases, dissecting the hormetic action of this key mediator in different tissues, with a special focus on skeletal muscle. Since IL-6 can act as an enhancer of detrimental factor associated with both aging and pathologic conditions, such as chronic inflammation and oxidative stress, this cytokine could represent a "Gerokine", a determinant of the switch from physiologic aging to age-related diseases.

An Evolutionary Model of “Sexual Conflict” Over Women's Age at Marriage: Implications for Child Mortality and Undernutrition

Background

Early women's marriage is associated with adverse outcomes for mothers and their offspring, including reduced human capital and increased child undernutrition and mortality. Despite preventive efforts, it remains common in many populations and is often favored by cultural norms. A key question is why it remains common, given such penalties. Using an evolutionary perspective, a simple mathematical model was developed to explore women's optimal marriage age under different circumstances, if the sole aim were to maximize maternal or paternal lifetime reproductive fitness (surviving offspring).

Methods

The model was based on several assumptions, supported by empirical evidence, regarding relationships between women's marital age and parental and offspring outcomes. It assumes that later marriage promotes women's autonomy, enhancing control over fertility and childcare, but increases paternity uncertainty. Given these assumptions, optimal marriage ages for maximizing maternal and paternal fitness were calculated. The basic model was then used to simulate environmental changes or public health interventions, including shifts in child mortality, suppression of women's autonomy, or promoting women's contraception or education.

Results

In the basic model, paternal fitness is maximized at lower women's marriage age than is maternal fitness, with the paternal optimum worsening child undernutrition and mortality. A family planning intervention delays marriage age and reduces child mortality and undernutrition, at a cost to paternal but not maternal fitness. Reductions in child mortality favor earlier marriage but increase child undernutrition, whereas ecological shocks that increase child mortality favor later marriage but reduce fitness of both parents. An education intervention favors later marriage and reduces child mortality and undernutrition, but at a cost to paternal fitness. Efforts to suppress maternal autonomy substantially increase fitness of both parents, but only if other members of the household provide compensatory childcare.

Conclusion

Early women's marriage maximizes paternal fitness despite relatively high child mortality and undernutrition, by increasing fertility and reducing paternity uncertainty. This tension between the sexes over the optimal marriage age is sensitive to ecological stresses or interventions. Education interventions seem most likely to improve maternal and child outcomes, but may be resisted by males and their kin as they may reduce paternal fitness.

Cardiometabolic Effects of Postnatal High-Fat Diet Consumption in Offspring Exposed to Maternal Protein Restriction In Utero

In recent decades, the high incidence of infectious and parasitic diseases has been replaced by a high prevalence of chronic and degenerative diseases. Concomitantly, there have been profound changes in the behavior and eating habits of families around the world, characterizing a "nutritional transition" phenomenon, which refers to a shift in diet in response to modernization, urbanization, or economic development from undernutrition to the excessive consumption of hypercaloric and ultra-processed foods. Protein malnutrition that was a health problem in the first half of the 20th century has now been replaced by high-fat diets, especially diets high in saturated fat, predisposing consumers to overweight and obesity. This panorama points us to the alarming coexistence of both malnutrition and obesity in the same population. In this way, individuals whose mothers were undernourished early in pregnancy and then exposed to postnatal hyperlipidic nutrition have increased risk factors for developing metabolic dysfunction and cardiovascular diseases in adulthood. Thus, our major aim was to review the cardiometabolic effects resulting from postnatal hyperlipidic diets in protein-restricted subjects, as well as to examine the epigenetic repercussions occasioned by the nutritional transition.

Association of early menarche with elevated BMI, lower body height and relative leg length among 14- to 16-year-old post-menarcheal girls from a Maya community in Yucatan, Mexico

Human body segments have different timing and tempo of growth. Early menarche (EM) as an indicator of early reproductive maturity results in a shortened height and leg length. Relatively larger trunk may increase risk for more body fat deposit and higher body mass index (BMI) due to the allometry of total body fat with body proportions. The objective of the study was to assess the association of EM with BMI, absolute body size [height, sitting height (SH), subischial leg length (SLL)] and relative body dimensions [sitting height to subischial leg length ratio (SHSLLR), relative subischial leg length (RSLL)] among 14- to 16-year-old post-menarcheal girls from a rural Maya community in Quintana Roo, Yucatan, Mexico. In a cross-sectional study, post-menarcheal girls (n=51) aged 14 to 16 years had EM (n=22) (<12 years of age) and not early menarche (NEM, n=29). Anthropometric measurements of height, weight, and SH were recorded. Derived variables were BMI, height and BMI-for-age z-scores, SLL, SHSLLR, and RSLL. Mean value of age at menarche (AM) was 13 years (EM 11 years, NEM 14 years). Mean values of height (EM 159 cm, NEM 164 cm), BMI (EM 20 kg/m2, NEM 19 kg/m2), sitting height (EM 81 cm, NEM 78 cm), SLL (EM 79 cm, NEM 85 cm), SHSLLR (EM 102.93%, NEM 92.03%), and RSLL (EM 49%, NEM 52%) were different (p<0.05) in the two groups. BMI showed significant negative correlation with AM (Pearson’s r=-0.29, p<0.04). Linear regression models adjusted for age showed that EM had different interrelationships (p<0.05) with body dimensions: positive with BMI, SH, SHSLLR, and negative with height, SLL, and RSLL. Earlier AM was associated with higher BMI, SH, SHSLLR and lower SLL, RSLL, explaining lower body height and leg length among the participant EM girls. In the light of life history theory, EM results in a growth trade-off, short stature and larger trunk relative to leg length that might enhance risk for body fat gain.

Exploring the effects of birth order on human lifespan in Polish historical populations, 1738–1968

While the relationships between birth order and later outcomes in life, including health and wealth, have been the subject of investigation for several decades, little or no data exist regarding the relationship between birth order and life expectancy in the Polish population. The aim of this study was to explore the link between birth order and lifespan in Polish historical populations. We obtained 8523 records from a historical dataset that was established for parishioners from the borough of Bejsce, including 4463 males and 4060 females. These data pertain to the populations that lived over a long period in a group of localities for which parish registers were well preserved. The Mann-Whitney U test, the Kruskal-Wallis ANOVA and ANCOVA were run. The results strongly suggest that birth order affects male longevity. However, no such association was found for females. On balance, the hypothesis that first-born boys live longer because they are born to relatively younger parents has received some empirical support and deserves further study. We hypothesise that the effects of birth order on human health and lifespan might be overshadowed by other factors, including educational attainment, socioeconomic status and lifestyle.

Developmental Origins of Metaflammation; A Bridge to the Future Between the DOHaD Theory and Evolutionary Biology

Metabolic syndrome refers to obesity-associated metabolic disorders that increase the risk of type 2 diabetes, coronary diseases, stroke, and other disabilities. Environmental imbalance during the early developmental period affects health and increases susceptibility to non-communicable diseases, including metabolic syndrome, in later life; therefore, the Developmental Origins of Health and Disease (DOHaD) theory was established. According to the DOHaD theory, the hypothesis of the energy-saving 'Thrifty Phenotype' in undernourished fetuses is one of the well-accepted schemes as a risk of developing metabolic syndrome. This phenotype is evolutionarily advantageous for survival of the fittest in a hangry environment after birth, a strong selection pressure, but increases the risk of developing metabolic syndrome under an obesogenic diet according to the 'Mismatch' hypothesis. Increasing evidences support that chronic inflammation pathophysiologically connects obesity to metabolic disorders in metabolic syndrome, leading to the concept of 'Metaflammation'. 'Metaflammation' in humans is proposed to originate from the evolutionary conservation of crosstalk between immune and metabolic pathways; however, few studies have investigated the contribution of evolutionary maladaptation to the pathophysiology of 'Metaflammation'. Therefore, it is promising to investigate 'Metaflammation' from the viewpoint of selective advantages and its 'Mismatch' to an unexpected environment in contemporary lifestyles, in consideration of the principal concept of evolutionarily conserved nutrient sensing and immune signaling systems.

Protein malnutrition during lactation affects thoracic aortic tunica media thickness in Wistar rat pups

PURPOSE

To evaluate the morphological effects of a low-protein diet during maternal lactation on the offspring's thoracic aorta.

METHODS

Two female Wistar rats were mated with male of the same species at 4 months of age. Until the birth of the pups, all animals received commercial rat chow. After giving birth, the puerperal females were divided into two groups and adjusted the litter to five puppies per group: a control group that received commercial feed, and an experimental group whose diet included the same amount of calories, but 8% lower protein content. All animals' masses were measured throughout the lactation period, and the pups were euthanized after weaning at 21 days of age. The thoracic aorta was removed, histologically processed and stained with Weigert's resorcin-fuchsin for histomorphometric analysis of tunica media thickness.

RESULTS

Although both groups were born with similar body mass, during the 21 days of lactation the restricted protein group gained only 39% of the body mass of the control group. Histomorphometric analysis revealed that the restricted protein group had a significantly lower mean tunica media thickness than the control group.

CONCLUSIONS

A low-protein diet for nursing mothers influences mass gain and aortic tunica media thickness in their offspring.

The Price of Surviving on Adrenaline: Developmental Programming Responses to Chronic Fetal Hypercatecholaminemia Contribute to Poor Muscle Growth Capacity and Metabolic Dysfunction in IUGR-Born Offspring

Maternofetal stress induces fetal programming that restricts skeletal muscle growth capacity and metabolic function, resulting in intrauterine growth restriction (IUGR) of the fetus. This thrifty phenotype aids fetal survival but also yields reduced muscle mass and metabolic dysfunction after birth. Consequently, IUGR-born individuals are at greater lifelong risk for metabolic disorders that reduce quality of life. In livestock, IUGR-born animals exhibit poor growth efficiency and body composition, making these animals more costly and less valuable. Specifically, IUGR-associated programming causes a greater propensity for fat deposition and a reduced capacity for muscle accretion. This, combined with metabolic inefficiency, means that these animals produce less lean meat from greater feed input, require more time on feed to reach market weight, and produce carcasses that are of less quality. Despite the health and economic implications of IUGR pathologies in humans and food animals, knowledge regarding their specific underlying mechanisms is lacking. However, recent data indicate that adaptive programing of adrenergic sensitivity in multiple tissues is a contributing factor in a number of IUGR pathologies including reduced muscle mass, peripheral insulin resistance, and impaired glucose metabolism. This review highlights the findings that support the role for adrenergic programming and how it relates to the lifelong consequences of IUGR, as well as how dysfunctional adrenergic signaling pathways might be effective targets for improving outcomes in IUGR-born offspring.

Association of early-life undernutrition and risk of dyslipidemia in adulthood: a population-based cohort study

BACKGROUND

The association of early-life undernutrition and dyslipidemia found in previous studies may be confounded by the uncontrolled age difference between exposed and unexposed participants. The study aimed to investigate the association of early-life undernutrition and the risk of dyslipidemia in adulthood with good control of the age variable.

METHODS

We took the Great Chinese Famine (1959-1961) as a natural experiment of severe undernutrition. This study was based on the baseline investigation of a population-based cohort in rural China. Undernutrition in early life was defined as being exposed to famine at younger than 3 years of age. Three approaches including Adjustment, Restriction, and Matching were applied to control the confounding effect of age. Logistic regression models were applied to evaluate the association between early-life famine and the presence of dyslipidemia. Stratified analysis by gender was also performed, and potential effect modification was tested by adding the interaction term of the famine exposure variable and gender into the model.

RESULTS

Undernutrition in early life was associated with increased risk of borderline high and above (BHA) levels of total cholesterol (TC, OR_Adjustment = 1.61; OR_Restriction = 1.56; OR_Matching = 1.87), triglycerides (TG, OR_Adjustment = 1.33; OR_Restriction = 1.30; OR_Matching = 1.34), low-density lipoprotein cholesterol (LDL-C, OR_Adjustment = 1.75; OR_Restriction = 1.53; OR_Matching = 1.77) and dyslipidemia (OR_Adjustment = 1.52; OR_Restriction = 1.45; OR_Matching = 1.60), as well as high levels of TC, TG, LDL-C and dyslipidemia. An inverse association of undernutrition and risk of low high-density lipoprotein cholesterol (HDL-C) was found. Female participants with undernutrition experience had an increased risk of BHA TG and LDL-C (TG: OR_{Adjustment, female} = 1.45; OR_{Restriction, female} = 1.39; OR_{Matching, female} = 1.51; LDL-C: OR_{Adjustment, female} = 2.11; OR_{Restriction, female} = 1.80; OR_{Matching, female} = 2.15), but this association was not found in males.

CONCLUSION

Early-life undernutrition increased the risk of TC, TG, LDL-C, and dyslipidemia. Gender would significantly modify this effect for TG and LDL-C. These results emphasize the importance of nutritional conditions in the early stages of life to long-term health consequences.

Eating habits, lifestyle factors and body weight status among Moroccan school adolescents (12–19 years): The case of Beni Mellal city

BACKGROUND: Overweight and obesity among children and adolescents are serious public health issues worldwide. A better understanding of the relationships between obesity and lifestyle factors is necessary for effective prevention and management of obesity in youth. AIMS: This study aimed to assess the prevalence of overweight/obesity and associated factors among schoolchildren aged 12–19 years at Beni Mellal city, Morocco. METHODS: A school based cross sectional study was carried out. A total of 516 children were included in the study. The nutritional status was classified according to the reference curves of WHO (2007). Multivariable logistic regression analysis was used to identify factors associated with overweight/obesity. The association between dependent and independent variables were assessed using odds ratio with 95% confidence interval and p value < 0.05 was considered statistically significant. RESULTS: The prevalence of overweight was 12.40% and that of obesity was 5.20%. Overweight and obesity were statistically associated with gender (Odds Ratio (OR) = 10.15[95% CI 1.37–3.81], p = 0.001); skipping breakfast (OR = 9.19 [95% CI 1.42–5.17], p = 0.002) and eating cake, pastry and biscuit 1 to 3 times per week (OR = 4.14 [95% CI 1.02–3.25], p = 0.04) and 4 or more times a week (OR = 7.83 [95% CI 1.31–4.66], p = 0.005). CONCLUSIONS: This study revealed that prevalence of overweight/obesity among school-aged children in Beni Mellal city was high. Thus, promoting healthy dietary practices, particularly improving fruit and vegetable intake is essential to reduce the burden of overweight and obesity. Furthermore, it is important to strengthen nutrition education about avoiding junk food consumption and encouraging regular physical activity.

Maternal investment, life-history trajectory of the off-spring and cardiovascular disease risk in Emirati females in the United Arab Emirates

Background

Variations in cardiovascular disease risk (CVD) are suggested to be partly influenced by factors that affect prenatal growth patterns and outcomes, namely degree of maternal investment (proxied by birth weight and gestational age). Using the life history trajectory model, this study investigates whether maternal investment in early prenatal life associates with menarcheal age and whether maternal investment affects CVD risk in adulthood and predicts adult size and adiposity levels.

Methods

A cross-sectional study was conducted among 94 healthy Emirati females. Birth weight, gestational age and menarcheal age were obtained. Anthropometrical measurements, body composition analysis, and blood pressure values were collected. Regression analyses were conducted to establish associations.

Results

There was no association between birth weight standard deviation score (SDS) and age at menarche. When investigating the associations of birth weight SDS and age at menarche with growth indices, it was found that only birth weight was positively and significantly associated with both height (β = 1.342 cm, 95% CI (0.12, 2.57), p = 0.032) and leg length (β = 0.968 cm, 95% CI (0.08, 1.86), p = 0.034). Menarcheal age was significantly and inversely associated with fat mass index (FMI) (β = − 0.080 cm, 95% CI (− 0.13, − 0.03), p = 0.002), but not with waist circumference and fat free mass index (FFMI) (p > 0.05). Birth weight SDS was positively and significantly associated with waist circumference (β = 0.035 cm, 95% CI (0.01, 0.06), p = 0.009), FMI (β = 0.087 cm, 95% CI (0.01, 0.16), p = 0.027), and FFMI (β = 0.485 cm, 95% CI (0.17, 0.80), p = 0.003). Birth weight SDS was not significantly associated with either systolic blood pressure (SBP) or diastolic blood pressure (DBP) (p > 0.05). However, FMI, waist circumference, and FFMI were positively and significantly associated with SBP. Regarding DBP, the relationship was negatively and significantly associated with only FFMI (β = − 1.6111 kg/m2, 95% CI (− 2.63, − 0.60), p = 0.002).

Conclusion

Although the results do not fully support that Emirati females fast-life history is associated with increased chronic disease risk, the data does suggest a link between restricted fetal growth in response to low maternal investment and metabolic and reproductive health.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-11182-0.

Different body parts' fat mass and corrected QT interval on the electrocardiogram: The Fasa PERSIAN Cohort Study

Background

Previous studies suggested that obesity and fat mass are associated with QT interval prolongation, but the role of different body parts' fat mass is unclear. The associations between total and regional fat mass (FM) and corrected QT interval (QTc) were investigated for the first time in this study.

Methods

In this sub-analysis of Fasa PERSIAN cohort Study data, 3217 subjects aged 35–70 entered our study. Body fat mass was assessed by bioelectrical impedance analysis and QTc interval calculated by the QT interval measured by Cardiax^® software from ECGs and Bazett’s formula. Uni- and multi-variable linear and logistic regression was performed in IBM SPSS Statistics v23.

Results

In males, the fat mass to fat-free mass (FM/FFM) ratio in the trunk, arms, total body, and legs were significantly higher in the prolonged QTc group (QTc > 450 ms). Trunk (B = 0.148), total (B = 0.137), arms (B = 0.124), legs (B = 0.107) fat mass index (FMI) showed significant positive relationship with continuous QTc (P-value < 0.001). Also, just the fat-free mass index of legs had significant positive associations with QTc interval (P-value < 0.05). Surprisingly, in females, the mean of FM/FFM ratio in trunk and legs in the normal QTc group had higher values than the prolonged QTc group (QTc > 470 ms). Also, none of the body composition variables had a significant correlation with continuous QTc.

Conclusion

Our study suggested that FMI ratios in the trunk, total body, arms, and legs were positively associated with QTc interval in males, respectively, from a higher to a lower beta-coefficient. Such associations were not seen in females. Our study implies that body fat mass may be an independent risk factor for higher QTc interval and, consequently, more cardiovascular events that should be investigated.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12872-021-02095-2.

Birth weight, childhood and adolescent growth and diabetes risk factors in 21-year-old Asian Indians: the Pune Children's Study

Our objective was to investigate associations of body size (birth weight and body mass index (BMI)) and growth in height, body fat (adiposity) and lean mass during childhood and adolescence, with risk markers for diabetes in young South Asian adults. We studied 357 men and women aged 21 years from the Pune Children's Study birth cohort. Exposures were 1) birth weight, 21-year BMI, both of these mutually adjusted, and their interaction, and 2) uncorrelated conditional measures of growth in height and proxies for gain in adiposity and lean mass from birth to 8 years (childhood) and 8 to 21 years (adolescence) constructed from birth weight, and weight, height, and skinfolds at 8 and 21 years. Outcomes were plasma glucose and insulin concentrations during an oral glucose tolerance test and derived indices of insulin resistance and secretion. Higher 21-year BMI was associated with higher glucose and insulin concentrations and insulin resistance, and lower disposition index. After adjusting for 21-year BMI, higher birth weight was associated with lower 120-min glucose and insulin resistance, and higher disposition index. In the growth analysis, greater adiposity gain during childhood and adolescence was associated with higher glucose, insulin and insulin resistance, and lower disposition index, with stronger effects from adolescent gain. Greater childhood lean gain and adolescent height gain were associated with lower 120-min glucose and insulin. Consistent with other studies, lower birth weight and higher childhood weight gain increases diabetes risk. Disaggregation of weight gain showed that greater child/adolescent adiposity gain and lower lean and height gain may increase risk.

Pregnancies in Diabetes and Obesity: The Capacity-Load Model of Placental Adaptation

Excess nutritional supply to the growing fetus, resulting from maternal diabetes and obesity, is associated with increased risks of fetal maldevelopment and adverse metabolic conditions in postnatal life. The placenta, interposed between mother and fetus, serves as the gateway between the two circulations and is usually considered to mediate maternal exposures to the fetus through a direct supply line. In this Perspective, however, we argue that the placenta is not an innocent bystander and mounts responses to fetal "signals of distress" to sustain its own adequate function and protect the fetus. We describe several types of protection that the placenta can offer the fetus against maternal metabolic perturbations and offer a theoretical model of how the placenta responds to the intrauterine environment in maternal diabetes and obesity to stabilize the fetal environment. Our approach supports growing calls for early screening and control of pregnancy metabolism to minimize harmful fetal outcomes.

Leptin administration during lactation leads to different nutritional, biometric, hemodynamic, and cardiac outcomes in prepubertal and adult female Wistar rats

Literature reports that insults, such as hormonal disturbances, during critical periods of development may modulate organism physiology and metabolism favoring cardiovascular diseases (CVDs) later in life. Studies show that leptin administration during lactation leads to cardiovascular dysfunction in young and adult male Wistar rats. However, there are sex differences regarding CVD. Thus, the present work aimed to investigate neonatal leptin administration's consequences on different outcomes in female rats at prepubertal and adult age. Newborn Wistar female rats were divided into two groups, Leptin and Control, receiving daily subcutaneous injections of this adipokine (8 μg/100 g) or saline for the first 10 of 21 d of lactation. Nutritional, biometric, hemodynamic, and echocardiographic parameters, as well as maximal effort ergometer performance, were determined at postnatal days (PND) 30 and 150. Leptin group presented lower food intake (p = 0.0003) and higher feed efficiency (p = 0.0058) between PND 21 and 30. Differences concerning echocardiographic parameters revealed higher left ventricle internal diameter (LVID) in systole (p = 0.0051), as well as lower left ventricle ejection fraction (LVEF) (p = 0.0111) and fractional shortening (FS) (p = 0.0405) for this group at PND 30. Older rats treated with leptin during lactation presented only higher LVID in systole (p = 0.0270). Systolic blood pressure and maximum effort ergometer test performance was similar between groups at both ages. These data suggest that nutritional, biometric, and cardiac outcomes due to neonatal leptin administration in female rats are age-dependent.

Inter-relationships between percentage body fat, relative subischial leg length and body mass index among adolescents and adults from the Limbu community of Darjeeling, West Bengal

Leg length in humans is considered to be an indicator of the long-term impact of quality of childhood living conditions and nutritional status. The main objective of this study was to evaluate the magnitude of association of percentage body fat (PBF) with relative subischial leg length (RSLL), adjusting for age, sex and body mass index (BMI), among adolescents and adults in a population of poor socioeconomic background in India. Data were taken from a cross-sectional study conducted in 2010-2014 among the Limbu community of Darjeeling, West Bengal - an indigenous community with poor socioeconomic background, low literacy rate, low income and inadequate living conditions. The study villages were located in the Himalayan and sub-Himalayan regions of Darjeeling. The present study sample comprised 97 adolescents aged 16-19 years (47 boys, 50 girls) and 260 adults aged 20-39 years (135 men, 125 women). Anthropometric measurements of stature/height (cm), weight (kg), sitting height (cm) and skinfold thicknesses (biceps, triceps, subscapular, suprailiac) (mm) were recorded. Derived variables were BMI (kg/m2), subischial leg length (SLL) (cm), RSLL (%), sum of four skinfolds (mm) and PBF (%). Significant sex differences at p<0.05 were observed for all anthropometric characteristics, except for body weight among adolescents and RSLL, subscapular and sum of four skinfolds in adults. The linear regression models adjusting for age and sex showed that RSLL had a negative relationship with PBF (p<0.05) among adolescents and adults. Higher body fat, independent of BMI, was correlated with lower RSLL among both adolescents and adults from the Limbu community, indicating a possible association with poor quality living conditions in childhood. However, this may also have been due to the allometry of total body fat with body proportions - a relatively larger trunk results in more body fat.

Influence of gestational and perinatal factors on body composition of full-term newborns

OBJECTIVE

To evaluate the influence of gestational and perinatal factors on body composition and birth weight of full-term newborns.

METHOD

This was a cross-sectional study, within a prospective cohort, consisting of 124 postpartum women and their newborns. Data included the following: maternal age; ethnicity; pre-gestational body mass index; gestational weight gain; parity; gestational morbidities (hypertension and gestational diabetes mellitus); gestational age at birth; birth weight; and newborn's gender. Anthropometric and body composition data of the newborns were collected using air-displacement plethysmography (PeaPod® Infant Body Composition System-LMI; Concord, CA, USA). The stepwise technique was applied to a multiple linear regression model.

RESULTS

The significant variables in the model that explained 84% of the variation in neonatal fat-free mass were: birth weight; maternal age; newborn's gender and gestational age. For body fat mass: birth weight; newborn's gender; gestational arterial hypertension; gestational diabetes; and gestational weight gain. These variables explained 60% and 46% of fat mass, in grams and as a percentage, respectively. Regarding birth weight, the significant factors were gestational age, pre-gestational BMI, and gestational weight gain. Female newborns showed higher body fat mass and male newborns had higher fat-free mass.

CONCLUSION

Gestational and perinatal factors influence neonatal body composition. Early identification of these gestational factors, which may be modifiable, is necessary to prevent obesity and chronic noncommunicable diseases in the future.

Foetal and childhood exposure to famine and the risks of cardiometabolic conditions in adulthood: A systematic review and meta-analysis of observational studies

A systematic review and meta-analysis of observational studies was performed to provide a deeper understanding of the associations between foetal and childhood exposure to famine and the risks of type 2 diabetes mellitus (T2DM), metabolic syndrome, hypertension, hyperglycaemia, dyslipidaemia, obesity, overweight, coronary heart disease, stroke, and nonalcoholic fatty liver disease (NAFLD) in adulthood. Both foetal and childhood exposure to famine were positively associated with the risks of T2DM (foetal exposure: RR 1.37, 95% CI, 1.23-1.52; childhood exposure: RR 1.33, 95% CI, 1.08-1.64), metabolic syndrome (RR 1.26, 95% CI, 1.07-1.50; RR 1.24, 95% CI, 1.13-1.35), hypertension (RR 1.30, 95% CI, 1.07-1.57; RR 1.33, 95% CI, 1.02-1.74), hyperglycaemia (RR 1.27, 95% CI, 1.11-1.45; RR 1.25, 95% CI, 1.10-1.42), dyslipidaemia (RR 1.48, 95% CI, 1.33-1.66; RR 1.27, 95% CI, 1.12-1.45), obesity (RR 1.19, 95% CI, 1.02-1.39; RR 1.13, 95% CI, 1.00-1.28), overweight (RR 1.17, 95% CI, 1.07-1.29; RR 1.07, 95% CI, 1.00-1.14), coronary heart disease (RR 1.22, 95% CI, 1.00-1.51; RR 1.21, 95% CI, 1.09-1.35), and moderate-to-severe NAFLD (RR 1.66, 95% CI, 1.07-2.57; RR 1.68, 95% CI, 1.41-1.99) in adulthood. No association was observed for the risks of stroke or mild NAFLD. Adjustments for age, alcohol, smoking, body mass index, and physical activity nullified some associations. The associations were generally stronger in women than in men. In summary, foetal and childhood exposure to famine may confer greater risks of developing certain cardiometabolic conditions in adulthood, particularly in women. The extent to which risks for cardiometabolic conditions are associated with early-life famine appears to be determined by certain factors in adulthood.

Early childhood malnutrition trajectory and lung function at preadolescence

OBJECTIVE

Chronic undernutrition is a common phenomenon in Bangladesh. However, information is grossly lacking to report the correlation between chronic undernutrition trajectory and lung function in children. The aim of the current study was to understand the association between early-childhood chronic undernutrition trajectory and lung function at preadolescence.

DESIGN

The current study is a part of the 9-year follow-up of a large-scale cohort study called the Maternal and Infant Nutrition Interventions in Matlab.

SETTINGS

The current study was conducted in Matlab, a sub-district area of Bangladesh that is located 53 km south of the capital, Dhaka.

PARTICIPANTS

A total of 517 children participated in lung function measured with a spirometer at the age of 9 years. Weight and height were measured at five intervals from birth till the age of 9 years.

RESULTS

Over half of the cohort have experienced a stunting undernutrition phenomenon up to 9 years of age. Children who were persistently or intermittently stunted showed lower forced expiratory volume (ml/s) than normal-stature children (P < 0·05). Children who exhibited catch-up growth throughout 4·5 years from the stunted group showed similar lung function with normal counterparts, and a better lung function than in children with the same growth velocity or who had faltering growth. In the multivariable models, similar associations were observed in children who experienced catch-up growth than their counterparts after adjusting for covariates.

CONCLUSION

Our data suggest that catch-up growth in height during early childhood is associated with a better lung function at preadolescence.

Excessive early-life cholesterol exposure may have later-life consequences for nonalcoholic fatty liver disease

The in utero and immediate postnatal environments are recognized as critical windows of developmental plasticity where offspring are highly susceptible to changes in the maternal metabolic milieu. Maternal hypercholesterolemia (MHC) is a pathological condition characterized by an exaggerated rise in maternal serum cholesterol during pregnancy which can program metabolic dysfunction in offspring, including dysregulation of hepatic lipid metabolism. Although there is currently no established reference range MHC, a loosely defined cutoff point for total cholesterol >280 mg/dL in the third trimester has been suggested. There are several unanswered questions regarding this condition particularly with regard to how the timing of cholesterol exposure influences hepatic lipid dysfunction and the mechanisms through which these adaptations manifest in adulthood. Gestational hypercholesterolemia increased fetal hepatic lipid concentrations and altered lipid regulatory mRNA and protein content. These early changes in hepatic lipid metabolism are evident in the postweaning environment and persist into adulthood. Further, changes to hepatic epigenetic signatures including microRNA (miR) and DNA methylation are observed in utero, at weaning, and are evident in adult offspring. In conclusion, early exposure to cholesterol during critical developmental periods can predispose offspring to the early development of nonalcoholic fatty liver disease (NAFLD) which is characterized by altered regulatory function beginning in utero and persisting throughout the life cycle.

Developmental plasticity as adaptation: adjusting to the external environment under the imprint of maternal capital

Plasticity is assumed to enable beneficial adjustment to the environment. In this context, developmental plasticity is generally approached within a two-stage framework, whereby adjustments to ecological cues in stage 1 are exposed to selection in stage 2. This conceptual approach may have limitations, because in species providing parental investment, particularly placental mammals such as humans, initial adjustments are not to the environment directly, but rather to the niche generated by parental phenotype (in mammals, primarily that of the mother). Only as maternal investment is withdrawn is the developing organism exposed directly to prevailing ecological conditions. A three-stage model may therefore be preferable, where developmental trajectory first adjusts to maternal investment, then to the external environment. Each offspring experiences a trade-off, benefitting from maternal investment during the most vulnerable stages of development, at the cost of exposure to investment strategies that maximize maternal fitness. Maternal life-history trade-offs impact the magnitude and schedule of her investment in her offspring, generating lifelong effects on traits related to health outcomes. Understanding the imprint of maternal capital on offspring is particularly important in species demonstrating social hierarchy. Interventions targeting maternal capital might offer new opportunities to improve health outcomes of both mother and offspring. This article is part of the theme issue 'Developing differences: early-life effects and evolutionary medicine'.

The double burden of malnutrition: aetiological pathways and consequences for health

Malnutrition has historically been researched and addressed within two distinct silos, focusing either on undernutrition, food insecurity, and micronutrient deficiencies, or on overweight, obesity, and dietary excess. However, through rapid global nutrition transition, an increasing proportion of individuals are exposed to different forms of malnutrition during the life course and have the double burden of malnutrition (DBM) directly. Long-lasting effects of malnutrition in early life can be attributed to interconnected biological pathways, involving imbalance of the gut microbiome, inflammation, metabolic dysregulation, and impaired insulin signalling. Life-course exposure to early undernutrition followed by later overweight increases the risk of non-communicable disease, by imposing a high metabolic load on a depleted capacity for homoeostasis, and in women increases the risk of childbirth complications. These life-course trajectories are shaped both by societal driving factors-ie, rapidly changing diets, norms of eating, and physical activity patterns-and by broader ecological factors such as pathogen burden and extrinsic mortality risk. Mitigation of the DBM will require major societal shifts regarding nutrition and public health, to implement comprehensive change that is sustained over decades, and scaled up into the entire global food system.

Life History Transitions at the Origins of Agriculture: A Model for Understanding How Niche Construction Impacts Human Growth, Demography and Health

Over recent millennia, human populations have regularly reconstructed their subsistence niches, changing both how they obtain food and the conditions in which they live. For example, over the last 12,000 years the vast majority of human populations shifted from foraging to practicing different forms of agriculture. The shift to farming is widely understood to have impacted several aspects of human demography and biology, including mortality risk, population growth, adult body size, and physical markers of health. However, these trends have not been integrated within an over-arching conceptual framework, and there is poor understanding of why populations tended to increase in population size during periods when markers of health deteriorated. Here, we offer a novel conceptual approach based on evolutionary life history theory. This theory assumes that energy availability is finite and must be allocated in competition between the functions of maintenance, growth, reproduction, and defence. In any given environment, and at any given stage during the life-course, natural selection favours energy allocation strategies that maximise fitness. We argue that the origins of agriculture involved profound transformations in human life history strategies, impacting both the availability of energy and the way that it was allocated between life history functions in the body. Although overall energy supply increased, the diet composition changed, while sedentary populations were challenged by new infectious burdens. We propose that this composite new ecological niche favoured increased energy allocation to defence (immune function) and reproduction, thus reducing the allocation to growth and maintenance. We review evidence in support of this hypothesis and highlight how further work could address both heterogeneity and specific aspects of the origins of agriculture in more detail. Our approach can be applied to many other transformations of the human subsistence niche, and can shed new light on the way that health, height, life expectancy, and fertility patterns are changing in association with globalization and nutrition transition.

Hormesis in Health and Chronic Diseases

'What doesn't kill you makes you stronger'. Hormesis, the paradoxical beneficial effects of low-dose stressors, can be better defined as the biphasic dose-effect or time-effect relationship for any substance. Here we review hormesis-like phenomena in the context of chronic diseases for many substances, including lifestyle factors and endocrine factors. Intermittent or pulsatile exposure can generate opposite effects compared with continuous exposure. An initial exposure can elicit an adaptive stress response with long-lasting protection against subsequent exposures. Early-life stress can increase resilience in later life and lack of stress can lead to vulnerability. Many stressors are naturally occurring and are required for healthy growth or homeostasis, which exemplifies how 'illness is the doorway to health'.

Knee osteoarthritis risk in non-industrial societies undergoing an energy balance transition: evidence from the indigenous Tarahumara of Mexico

Non-industrial societies with low energy balance levels are expected to be less vulnerable than industrial societies to diseases associated with obesity including knee osteoarthritis. However, as non-industrial societies undergo rapid lifestyle changes that promote positive energy balance, individuals whose metabolisms are adapted to energetic scarcity are encountering greater energy abundance, increasing their propensity to accumulate abdominal adipose tissue and thus potentially their sensitivity to obesity-related diseases.

OBJECTIVES

Here, we propose that knee osteoarthritis is one such disease for which susceptibility is amplified by this energy balance transition.

METHODS

Support for our hypothesis comes from comparisons of knee radiographs, knee pain and anthropometry among men aged ≥40 years in two populations: Tarahumara subsistence farmers in Mexico undergoing the energy balance transition and urban Americans from Framingham, Massachusetts.

RESULTS

We show that despite having markedly lower obesity levels than the Americans, the Tarahumara appear predisposed to accrue greater abdominal adiposity (ie, larger abdomens) for a given body weight, and are more vulnerable to radiographic and symptomatic knee osteoarthritis at lower levels of body mass index. Also, proportionate increases in abdomen size in the two groups are associated with greater increases in radiographic knee osteoarthritis risk among the Tarahumara than the Americans, implying that the abdominal adipose tissue of the Tarahumara is a more potent stimulus for knee degeneration.

CONCLUSIONS

Heightened vulnerability to knee osteoarthritis among non-industrial societies experiencing rapid lifestyle changes is a concern that warrants further investigation since such groups represent a large but understudied fraction of the global population.

Understanding the rise of cardiometabolic diseases in low- and middle-income countries

Increases in the prevalence of noncommunicable diseases (NCDs), particularly cardiometabolic diseases such as cardiovascular disease, stroke and diabetes, and their major risk factors have not been uniform across settings: for example, cardiovascular disease mortality has declined over recent decades in high-income countries but increased in low- and middle-income countries (LMICs). The factors contributing to this rise are varied and are influenced by environmental, social, political and commercial determinants of health, among other factors. This Review focuses on understanding the rise of cardiometabolic diseases in LMICs, with particular emphasis on obesity and its drivers, together with broader environmental and macro determinants of health, as well as LMIC-based responses to counteract cardiometabolic diseases.

Higher Weight and Weight Gain after 4 Years of Age Rather than Weight at Birth Are Associated with Adiposity, Markers of Glucose Metabolism, and Blood Pressure in 5-Year-Old Ethiopian Children

BACKGROUND

Fetal and early life growth is associated with adult risk of obesity and cardiometabolic disease. However, little is known about the relative importance of birth weight and successive periods of weight gain on markers of cardiometabolic risk in childhood in low-income populations.

OBJECTIVES

The objective was to study associations of birth weight and weight gain velocities in selected age intervals from birth to 60 mo with height, fat-free mass (FFM), and markers of adiposity and cardiometabolic risk at 60 mo.

METHODS

In a prospective cohort study of 375 Ethiopian children aged 60 mo, we estimated individual weight gain velocities in the periods between birth and 3, 6, 24, 48, and 60 mo using linear-spline mixed-effects modeling. Subsequently, we analyzed associations of birth weight, weight gain velocities, and current weight with height, FFM, and markers of adiposity and cardiometabolic risk.

RESULTS

Weight gain from 48 to 60 mo and weight at 60 mo rather than birth weight were the strongest correlates of insulin, C-peptide, HOMA-IR, blood pressure, height, FFM, waist circumference, and fat mass at 60 mo. For instance, 1 SD higher (1 SD = 50 g/mo) weight accretion from 48 to 60 mo was associated with a higher insulin of 23.3% (95% CI: 9.6%, 38.8%), C-peptide of 11.4% (2.7%, 20.8%), systolic blood pressure of 1.4 mm Hg (0.6, 2.3 mm Hg), fat mass of 0.72 kg (0.59, 0.85 kg), and FFM of 0.70 kg (0.56, 0.85 kg). Weight gain from 0 to 3 mo was positively associated with LDL cholesterol, systolic blood pressure, height, and the body composition indices, and weight gain from 24 to 48 mo was inversely associated with blood glucose.

CONCLUSIONS

In 60-mo-old Ethiopian urban children, weight gain and weight after 48 mo rather than weight at birth may represent a sensitive period for variations in markers of adiposity and glucose metabolism. The birth cohort is registered at https://www.isrctn.com/ as ISRCTN46718296.

The diabesity epidemic in the light of evolution: insights from the capacity-load model

The global nutrition transition, which embraces major changes in how food is produced, distributed and consumed, is associated with rapid increases in the prevalence of obesity, but the implications for diabetes differ between populations. A simple conceptual model treats diabetes risk as the function of two interacting traits: 'metabolic capacity,' which promotes glucose homeostasis, and 'metabolic load', which challenges glucose homoeostasis. Population variability in diabetes prevalence is consistent with this conceptual model, indicating that the effect of obesity varies by ethnicity. Evolutionary life history theory can help explain why variability in metabolic capacity and metabolic load emerges. At the species level (hominin evolution), across human populations and within individual life courses, phenotypic variability emerges under selective pressure to maximise reproductive fitness rather than metabolic health. Those exposed to adverse environments may express or develop several metabolic traits that are individually beneficial for reproductive fitness, but which cumulatively increase diabetes risk. Public health interventions can help promote metabolic capacity, but there are limits to the benefits that can emerge within a single generation. This means that efforts to curb metabolic load (obesity, unhealthy lifestyles) must remain at the forefront of diabetes prevention. Such efforts should go beyond individuals and target the broader food system and socioeconomic factors, in order to maximise their efficacy.