The developmental origins of adult disease hypothesisEpidemiological studies of many large populations indicate that non-communicable diseases in adulthood are related to factors in fetal life or during infancy [1]. Low birthweight or disproportion at birth are associated with increased risk of cardiovascular disease and type-II diabetes. These associations have been explained in terms of developmental programming, which is the process through which insults or stimuli during early life exert permanent effects upon organ development, physiology and metabolism [18]. Variation in the nutrient supply during fetal has been proposed as the major programming stimulus that determines risk of disease in adulthood.Studies of human cohorts have mainly required the use of retrospective cohorts and this has raised serious issues regarding control for confounding factors, selection bias and measurement bias [11]. Moreover, within relatively well-nourished populations variation in maternal nutrient intakes are noted to have little impact upon patterns of fetal growth or birthweight [17], which has led some observers to question the plausibility of the developmental origins of adult disease hypothesis. Experimental studies employing small animal species (e.g. rat, mouse or guinea pig) or larger species (pig and sheep) have, however, clearly demonstrated the biological plausibility of nutritional programming [25]. A diverse range of nutritional manipulations in pregnancy have been shown to programme profound changes in tissue morphology, physiology and metabolism and often these changes occur independently of fetal growth retardation [25].
Animal models of cardiovascular programmingAlthough the approaches used to manipulate the maternal diet in order to test the developmental programming hypothesis have been varied, cardiovascular changes in the resultant offspring are a near universal outcome. Global nutrient restriction during pregnancy (controlled reductions of maternal nutrient intake) in rodents [36] and in sheep [9] produces small changes in blood pressure in the adult offspring, which often only manifest at maturity. Similar delays in the appearance of blood pressure changes are noted with the feeding of high-saturated fat diets [15] or iron deficient diets [8] to pregnant rats. In contrast the marked increase in blood pressure and variation in vascular reactivity to vasoconstrictors and relaxants that follows intrauterine protein restriction [7,16] tends to manifest very early in the postnatal period (Fig. 1).One of the major drawbacks of working with rodent species is the fact that these are generally resistant to the development of atherosclerosis. Thus, whilst nutritional programming of cardiovascular risk factors is demonstrable, the development of coronary heart disease is difficult to model in animals. Ongoing studies with transgenic lines which develop vascular lesions in response to high fat-high cholesterol diets, for example the apo E*3 Leiden strain [10], will yield important data in this area over the next fe...