Epidemiological Studies of the Developmental Origins of Adult Health and Disease in Japan: A Pediatric Perspective in Present Day Japan

Abstract

The origins of adult disease are considered to relate to fetal undernutrition, and this concept is termed “developmental origins of adult health and disease” (DOHaD). Here, we describe several epidemiological studies performed in Japan and discuss whether DOHaD is applicable to children in present day Japan. In a study of healthy children and young adults, it was found that systolic blood pressure, total cholesterol and adiponectin were associated with birth weight. Hyperinsulinemia, high blood pressure, elevated transaminase levels and prevalence of metabolic syndrome in obese children were inversely correlated with birth weight and positively correlated with current weight and waist circumference. Birth weight was related to the development of type 2 diabetes in children. DOHaD is therefore considered to be applicable in Japan. The key considerations of DOHaD are the following two mismatches. The first mismatch pertains to growth and development in response to environmental influences, especially those of nutrition. The second mismatch pertains to the prenatal versus postnatal environment. We consider that the chance of children in present day Japan developing adult diseases is determined by the above mismatches. Pediatricians and schoolteachers should therefore understand the concept of DOHaD, so that they can educate both children and their families regarding an appropriate diet to reduce the likelihood of developing adult diseases in later life.

Childhood obesity: rapid weight gain in early childhood and subsequent cardiometabolic risk

“…The benefits of CUG for later neurodevelopment favors the promotion of rapid growth in infants born preterm; however, CUG in infants born at term (normal or low birth weight for gestation) is likely to have adverse effects on long-term health ( 75 ). Children born with low birth weight or SGA have an increased risk for non-communicable diseases (NCDs) such as type 2 diabetes and cardiovascular disease later in life, as illustrated by the concept of Developmental Origins of Health and Disease (DOHaD) ( 76 , 77 , 78 , 79 , 80 ). Poor maternal nutritional status or smoking during pregnancy are major causes of intrauterine growth restriction ( 76 , 77 ).…”

Effect of maternal active smoking during pregnancy on the trajectory of childhood body mass index: A multilevel analysis using quartiles of birthweight

“…In contrast, birthweights in the third and fourth quartiles were higher than the median regardless of maternal active smoking during pregnancy, implying the effect of opposing factors that increase birthweight, like appropriate gestational weight gain. The concept of DOHaD suggests that mismatched foetal and early infant environments might adversely affect future health status 41 . Therefore, in these quartiles, appropriate foetal factors that increase birthweight might reduce the adverse effects of maternal active smoking during pregnancy on childhood BMI.…”

Elevated blood pressure in high-fat diet-exposed low birthweight rat offspring is most likely caused by elevated glucocorticoid levels due to abnormal pituitary negative feedback

“…In Japan, an increase in the rate of LBW infants has been reported to be remarkably elevated for over a decade, and it is an urgent task to control the future development of non-communicable chronic diseases in these children [15,16]. However, verification of the mechanisms underlying the adult onset of hypertension caused by LBW in humans is time consuming and has many ethical problems.…”