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Wells JCK, Desoye G, Leon DA. Reconsidering the developmental origins of adult disease paradigm: The 'metabolic coordination of childbirth' hypothesis. Evol Med Public Health 2024; 12:50-66. [PMID: 38380130 PMCID: PMC10878253 DOI: 10.1093/emph/eoae002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 12/18/2023] [Indexed: 02/22/2024] Open
Abstract
In uncomplicated pregnancies, birthweight is inversely associated with adult non-communicable disease (NCD) risk. One proposed mechanism is maternal malnutrition during pregnancy. Another explanation is that shared genes link birthweight with NCDs. Both hypotheses are supported, but evolutionary perspectives address only the environmental pathway. We propose that genetic and environmental associations of birthweight with NCD risk reflect coordinated regulatory systems between mother and foetus, that evolved to reduce risks of obstructed labour. First, the foetus must tailor its growth to maternal metabolic signals, as it cannot predict the size of the birth canal from its own genome. Second, we predict that maternal alleles that promote placental nutrient supply have been selected to constrain foetal growth and gestation length when fetally expressed. Conversely, maternal alleles that increase birth canal size have been selected to promote foetal growth and gestation when fetally expressed. Evidence supports these hypotheses. These regulatory mechanisms may have undergone powerful selection as hominin neonates evolved larger size and encephalisation, since every mother is at risk of gestating a baby excessively for her pelvis. Our perspective can explain the inverse association of birthweight with NCD risk across most of the birthweight range: any constraint of birthweight, through plastic or genetic mechanisms, may reduce the capacity for homeostasis and increase NCD susceptibility. However, maternal obesity and diabetes can overwhelm this coordination system, challenging vaginal delivery while increasing offspring NCD risk. We argue that selection on viable vaginal delivery played an over-arching role in shaping the association of birthweight with NCD risk.
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Affiliation(s)
- Jonathan C K Wells
- Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK
| | - Gernot Desoye
- Department of Obstetrics and Gynaecology, Medical University of Graz, Auenbruggerplatz 14, 8036 Graz, Austria
| | - David A Leon
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
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Gharibeh N, Gallo S, Sotunde OF, Vanstone CA, Rodd CJ, Weiler HA. Patterns of Bone Mineral Accretion and Sex Differences in Healthy Term Vitamin D Replete and Breastfed Infants From Montreal, Canada: Bone Mass Reference Data. J Clin Densitom 2022; 25:43-53. [PMID: 34479797 DOI: 10.1016/j.jocd.2021.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 06/24/2021] [Accepted: 07/06/2021] [Indexed: 11/27/2022]
Abstract
Infancy is a period of rapid bone growth and mineral accretion; nonetheless, reference data remain scarce for this age group. The purpose of this report is to generate reference data for bone mass in breastfed vitamin D replete infants and investigate patterns of bone mineral accretion and sex differences. This is a secondary analysis from a double-blinded randomized controlled trial (NCT00381914). Healthy term breastfed (exclusively or mixed) infants were randomized to different doses of oral vitamin D supplementation (400-1600 IU/d) and followed prospectively from 1 to 12 mo. Plasma 25-hydroxyvitamin D (LC-MS/MS), bone mineral content (BMC; whole body (WB) and lumbar spine (LS)) and bone mineral density (BMD; LS) were measured at 1, 3, 6, 9, and 12 mo by dual-energy x-ray absorptiometry (Hologic Discovery 4500A) with no effect of supplementation on bone outcomes. For the purpose of this analysis, 63 infants with adequate plasma 25-hydroxyvitamin D ≥ 50 nmol/L at baseline, were included. Differences over time and between sexes were tested using mixed model repeated measures ANOVA. Infants (31 males, 32 females) were 39.5 ± 1.1 wk gestational age at birth and appropriate for gestational age. WB BMC, LS BMC, and LS BMD increased by 143.2%, 116.8%, and 31.1% respectively across infancy. WB BMC was higher (4.2% - 9.4%; p = 0.03) in males than in females across the study. After adjusting WB BMC for weight, length or head BMC, sex differences were not evident. LS BMC and LS BMD did not vary by sex. LS BMD growth charts for both sexes combined, were generated using LMS chartmaker. WB BMC more than doubles during the first year of life confirming the importance of skeletal growth and the need for age-specific reference data in infancy. Sex differences in BMC, if any, are mostly driven by differences in body size.
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Affiliation(s)
- Nathalie Gharibeh
- School of Human Nutrition, McGill University, Ste-Anne-de-Bellevue, Québec, Canada
| | - Sina Gallo
- Foods and Nutrition, University of Georgia, Athens, Georgia, USA
| | - Olusola F Sotunde
- School of Human Nutrition, McGill University, Ste-Anne-de-Bellevue, Québec, Canada
| | - Catherine A Vanstone
- School of Human Nutrition, McGill University, Ste-Anne-de-Bellevue, Québec, Canada
| | - Celia J Rodd
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Hope A Weiler
- School of Human Nutrition, McGill University, Ste-Anne-de-Bellevue, Québec, Canada; Nutrition Research Division, Bureau of Nutritional Sciences, Health Products and Food Branch, Health Canada, Ottawa, Ontario, Canada..
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Birthweight-for-gestational-age z-scores are associated with early childhood cardiometabolic health in the Peri/Postnatal Epigenetic Twin Study. J Dev Orig Health Dis 2021; 13:514-522. [PMID: 34420534 DOI: 10.1017/s2040174421000465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Birthweight has been consistently related to risk of cardiometabolic disorders in later life. Twins are at higher risk of low birthweight than singletons, so understanding the links between birthweight and cardiometabolic health may be particularly important for twins. However, evidence for the association of birthweight with childhood markers of cardiometabolic health in twins is currently lacking. Previous studies have often failed to appropriately adjust for gestational age or fully implement twin regression models. Therefore, we aimed to evaluate the association of birthweight-for-gestational-age z-scores with childhood cardiometabolic health in twins, using within-between regression models. The Peri/Postnatal Epigenetic Twins Study is a Melbourne-based prospective cohort study of 250 twin pairs. Birthweight was recorded at delivery, and childhood anthropometric measures were taken at 18-month and 6-year follow-up visits. Associations of birthweight with markers of cardiometabolic health were assessed at the individual, between- and within-pair level using linear regression with generalised estimating equations. Birthweight-for-gestational-age z-scores were associated with height, weight and BMI at 18 months and 6 years, but not with blood pressure (twins-as-individual SBP: β = 0.15, 95% CI: -0.81, 1.11; twins-as-individual DBP: β = 0.22, 95% CI: -0.34, 0.77). We found little evidence to indicate that the within-between models improved on the twins-as-individuals models. Birthweight was associated with childhood anthropometric measures, but not blood pressure, after appropriately adjusting for gestational age. These associations were consistent across the within-between and twins-as-individuals models. After adjusting for gestational age, results from the twins-as-individuals models are consistent with singleton studies, so these results can be applied to the general population.
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Forma V, Anderson DI, Provasi J, Soyez E, Martial M, Huet V, Granjon L, Goffinet F, Barbu-Roth M. What Does Prone Skateboarding in the Newborn Tell Us About the Ontogeny of Human Locomotion? Child Dev 2019; 90:1286-1302. [PMID: 31267516 DOI: 10.1111/cdev.13251] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The crawling behavior of sixty 2-day-old newborns was studied while they were supported prone on a mini skateboard and on a pediatric mattress without additional support. Analyses of the number and types of limb movements and their characteristics, the coactivation of limb pairs, and the displacement across the surface, revealed that newborns can crawl with locomotor patterns similar to those documented during quadrupedal locomotion in animals and human adults. This was particularly apparent on the skateboard. This discovery suggests that locomotor circuitry underlying quadrupedal locomotion develops during fetal life. Drawing upon other evidence for a quadrupedal organization underlying bipedal gait, we argue that early quadrupedal training may enhance interventions designed to hasten the onset of independent walking.
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Waxenbaum EB, Warren MW, Holliday TW, Byrd JE, Cole TM. Ecogeographic patterns in fetal limb proportions. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2019; 169:93-103. [PMID: 30848485 DOI: 10.1002/ajpa.23814] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Revised: 02/06/2019] [Accepted: 02/19/2019] [Indexed: 11/11/2022]
Abstract
OBJECTIVES Humans generally comply with the ecological rule of Allen (1877), with populations from tropical environments exhibiting body proportions in which limb segments are long relative to trunk height compared to temperate groups. This study tests whether ecogeographic differences in intralimb proportions are identifiable among two modern fetal samples of differing ancestry. MATERIALS AND METHODS Data are derived from radiographic measurements of long bone diaphyseal length and crown-heel length (CHL) of contemporary, spontaneously aborted fetuses of African Americans ("black") of assumed African (tropical) ancestry and European Americans ("white") of assumed European (temperate) ancestry (n = 184). Population individual limb elements, brachial, and crural indices are compared via analyses of covariance (ANCOVA). Potential patterns of divergent allometric growth are quantified through principal components analysis (PCA). RESULTS African ancestral distal limb elements were consistently, albeit slightly, longer than those of European ancestry, relative to CHL. None of the ANCOVA interactions with ancestry are statistically significant for limb indices. The radius was the only single element that displayed a statistically significant ancestry effect (p = 0.0435) equating to a 1 mm difference. PCA highlights that upper limbs demonstrate negative allometry and lower limbs demonstrate positive allometry with sample-specific multivariate growth patterns being nearly identical. Differences in growth allometry late in gestation make little contribution to observed differences in adult limb proportions. DISCUSSION No statistically significant ecogeographic patterns were appreciated among intralimb proportions between these groups during the fetal period. This study contributes to a greater appreciation of phenotypic plasticity, ecogeographic variation in ontogeny, and the evolution of modern human diversity.
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Affiliation(s)
- Erin B Waxenbaum
- Department of Anthropology, Northwestern University, Evanston, Illinois
| | - Michael W Warren
- Department of Anthropology, University of Florida, Gainesville, Florida
| | - Trenton W Holliday
- Department of Anthropology, Tulane University, New Orleans, Louisiana
- Evolutionary Studies Institute, University of the Witwatersrand, Wits, Republic of South Africa
| | - John E Byrd
- Defense POW/MIA Accounting Agency, Central Identification Laboratory, Hickam AFB, Hawaii
| | - Theodore M Cole
- Department of Biomedical Sciences, University of Missouri - Kansas City, Kansas City, Missouri
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Forma V, Anderson DI, Goffinet F, Barbu-Roth M. Effect of optic flows on newborn crawling. Dev Psychobiol 2018; 60:497-510. [PMID: 29851061 DOI: 10.1002/dev.21634] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Revised: 02/27/2018] [Accepted: 02/28/2018] [Indexed: 12/12/2022]
Abstract
This study examined the crawling characteristics of newborns placed prone on a water-filled, transparent pediatric mattress and whether exposure to terrestrial optic flows that specify forward and backward displacement would influence leg and arm crawling movements. Twenty-six 3-day-old newborns were exposed to a static checkerboard pattern that was back-projected onto the surface underneath the mattress or a checkerboard pattern that moved toward or away from them at 0.12 m/s. Significantly more flexion and extension crawling movements of the legs were observed in the optic flow conditions, although infants did not displace their bodies significantly further on the mattress in these conditions. Unique aspects of newborn crawling were also identified.
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Affiliation(s)
- Vincent Forma
- Laboratoire Psychologie de la Perception, Université Paris Descartes, CNRS, Paris, France
| | - David I Anderson
- Marian Wright Edelman Institute, San Francisco State University, San Francisco, CA
| | - François Goffinet
- Université Paris Descartes, Maternité Port-Royal, AP-HP, Paris, France
| | - Marianne Barbu-Roth
- Laboratoire Psychologie de la Perception, Université Paris Descartes, CNRS, Paris, France
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Abstract
Skin fold thickness (SFT) measurement is a reliable, cheap, simple, noninvasive method of body fat estimation at all ages including the neonatal period. Objective. To determine reference values of biceps, triceps, subscapular, and suprailiac skinfold thickness measurements in term Nigerian newborns. Method. A prospective cross-sectional study over a six-month period (Dec 2010-May 2011) was carried out on term and healthy neonates delivered between 37 and 41 weeks. The anthropometric measurements were taken within the first 48 hours of life including the skinfold thickness. The skinfold thickness measurements were taken at four sites, namely, triceps, biceps, subscapular, and suprailiac, using Harpenden skinfold calipers. The mean of two readings was recorded. Result. A total of one thousand one hundred and sixty-eight neonates were studied. The birth weight ranged between 2000 g and 5000 g with a mean birth weight of the neonates at 3259 ± 470 g. The mean birth weight of the males (3339 ± 0.45) was significantly higher than that of females (3200 ± 0.44) (p < 0.0001). Female neonates had higher mean values of triceps, subscapular, and suprailiac skinfold thickness (p < 0.001, resp.) while male neonates had higher mean value of biceps skinfold thickness (p = 0.008). Females also had higher mean values of the sum of skinfold thicknesses at all four sites and the sum at the two truncal sites at every stratified gestational age. Conclusions. The sex specific percentile chart developed for skinfold thickness measurements can be used to detect deviation from the reference population such that infants who are at risk of nutritional or health problems are identified early, and intervention is instituted promptly.
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Wells JC. Worldwide variability in growth and its association with health: Incorporating body composition, developmental plasticity, and intergenerational effects. Am J Hum Biol 2017; 29. [DOI: 10.1002/ajhb.22954] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Revised: 10/24/2016] [Accepted: 12/10/2016] [Indexed: 12/11/2022] Open
Affiliation(s)
- Jonathan C.K. Wells
- UCL Great Ormond Street Institute of Child Health; 30 Guilford Street London WC1N 1EH United Kingdom
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Wells JCK, Devakumar D, Grijalva-Eternod CS, Manandhar DS, Costello A, Osrin D. Blood pressure and the capacity-load model in 8-year-old children from Nepal: Testing the contributions of kidney size and intergenerational effects. Am J Hum Biol 2016; 28:555-65. [PMID: 26848931 PMCID: PMC7611548 DOI: 10.1002/ajhb.22829] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Revised: 10/08/2015] [Accepted: 12/21/2015] [Indexed: 12/13/2022] Open
Abstract
Objectives Growth patterns in early life are increasingly linked with subsequent cardio-metabolic risk, but the underlying mechanisms require elucidation. We have developed a theoretical model of blood pressure, treating it as a function of homeostatic metabolic capacity, and antagonistic metabolic load. We sought to differentiate prenatal and postnatal components of metabolic capacity, and to identify intergenerational contributions to offspring capacity and load. Methods We followed up at 8 years a cohort of children originally recruited into a randomized trial of maternal micronutrient supplementation in pregnancy. Maternal anthropometry was measured at recruitment. Offspring anthropometry was measured at birth, 2 years and 8 years. Offspring blood pressure, kidney size, and body composition were measured at 8 years. Regression analysis was used to investigate potential associations of maternal phenotype, birth phenotype, and current body composition with kidney size and blood pressure. Results Blood pressure was positively associated with body fat, but negatively associated with birth weight and relative leg length. Kidney size was positively associated with birth weight but not with relative leg length. Adjusting for adiposity, blood pressure was independently negatively associated with birth weight, relative leg length, and kidney length. Maternal height and BMI predicted offspring size at birth and at 8 years, but not blood pressure. Conclusions Our data provide support for the capacity-load model of blood pressure in Nepalese children. Fetal and postnatal growth and kidney dimensions all contribute to metabolic capacity. Maternal phenotype contributed to offspring capacity and load, but these associations did not propagate to blood pressure.
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Affiliation(s)
- Jonathan C K Wells
- Childhood Nutrition Research Centre, UCL Institute of Child Health, London, United Kingdom
| | | | | | | | | | - David Osrin
- UCL Institute for Global Health, London, United Kingdom
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Abstract
PURPOSE OF REVIEW Human leg length is determined by a complex interplay of genetics and environmental exposures during development, which may be associated with long-term metabolic disease risk. Here, we review recent literature on the link between relative leg length and type 2 diabetes in more and less economically developed societies, wherein the contextual influences on relative leg length are unique. We also hypothesize mechanisms underlying and mediating this association. RECENT FINDINGS Evidence from more economically prosperous Western populations and contemporary adult populations in China and Brazil indicates that lower relative leg length is associated with greater risk for impaired glucose homeostasis and type 2 diabetes. In Brazil, this association was stronger among women with early menarche. Although still poorly defined and in need of further research, the potential mechanisms likely involve suboptimal early-life net nutrition that simultaneously leads to retarded growth and impaired glucose regulation. An untested hypothesis is that the association is mediated by differences in skeletal muscle mass. SUMMARY Epidemiologic evidence from diverse settings points to humans with shorter legs relative to their stature having higher risk for type 2 diabetes. Although research is needed to test mechanistic hypotheses, the greatest potential for improving public health will come through identification of, and intervention upon, the upstream modifiable determinants of inadequate leg growth.
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Affiliation(s)
- Noel T Mueller
- aDepartment of Epidemiology, Mailman School of Public Health bDepartment of Medicine, Columbia University Medical Center, College of Physicians and Surgeons, Institute of Human Nutrition, New York, New York cDivision of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
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