Influence of gestational salt restriction in fetal growth and in development of diseases in adulthood

Abstract

Recent studies reported the critical role of the intrauterine environment of a fetus in growth or the development of disease in adulthood. In this article we discussed the implications of salt restriction in growth of a fetus and the development of growth-related disease in adulthood. Salt restriction causes retardation of fatal growth or intrauterine death thereby leading to low birth weight or decreased birth rate. Such retardation of growth along with the upregulation of the renin angiotensin system due to salt restriction results in the underdevelopment of cardiovascular organs or decreases the number of the nephron in the kidney and is responsible for onset of hypertension in adulthood. In addition, gestational salt restriction is associated with salt craving after weaning. Moreover, salt restriction is associated with a decrease in insulin sensitivity. A series of alterations in metabolism due to salt restriction are probably mediated by the upregulation of the renin angiotensin system and an epigenetic mechanism including proinflammatory substances or histone methylation. Part of the metabolic disease in adulthood may be programmed through such epigenetic changes. The modification of gene in a fetus may be switched on through environment factors or life style after birth. The benefits of salt restriction have been assumed thus far; however, more precise investigation is required of its influence on the health of fetuses and the onset of various diseases in adulthood.

Terapéutica fetal no invasiva

“…En los seres humanos, es limitada la evidencia directa de la asociación etiológica de la restricción de sal gestacional y retraso del crecimiento de los recién nacidos. Recientemente, sin embargo, ha habido un número creciente de estudios que apoyan la hipótesis (12) . Originalmente, se informó que la hiperémesis gravídica suele estar asociada con peso bajo al nacer o parto prematuro y la pérdida de la sal resultante de vómitos se cree pueda ser responsable del peso bajo al nacer.…”

“…Originalmente, se informó que la hiperémesis gravídica suele estar asociada con peso bajo al nacer o parto prematuro y la pérdida de la sal resultante de vómitos se cree pueda ser responsable del peso bajo al nacer. Por otra parte, Shirazki y col., referido por Hiroe Sakuyama (12) , encontraron que los recién nacidos con concentraciones de sodio bajo en la sangre resultante de la baja ingesta de sal de su madre durante el embarazo tienen más probabilidades de tener peso bajo al nacer y posiblemente se vinculen a enfermedades en el adulto (diagrama 1).…”

“…La existencia de un transporte facilitado materno fetal de casi todas las vitaminas ha estimulado la tentativa terapéutica intraútero con vitaminas (cianocobalamina, biotina, rivoflavina y piridoxina) a fetos con presunto trastorno metabólico dependiente de vitaminas (mutaciones de la aciduria metilmalónica, homocistinuria sensidiagrama 1. repercusiones a corto y largo plazo de la restricción de sal en la dieta materna (12) Restricción de sal El inconveniente sería el enmascaramiento del diagnóstico neonatal, es decir, no aparecerían los signos bioquímicos que permitan confirmar el diagnóstico inmediatamente después del nacimiento. Las enfermedades relacionadas con los ácidos orgánicos (OAD, del inglés organic acid disorders) son un grupo de enfermedades hereditarias poco usuales (13) .…”

Renal impairment induced by prenatal exposure to angiotensin II in male rat offspring

“…Up-regulation of RAAS can be observed in response to different maternal conditions such as dehydration, 13 reduced salt intake, 14 gestational diabetes, 15 or disordered renal function. 16 Deregulation of RAAS during pregnancy and early postnatal period can alter fluid and ion homeostasis resulting in a deregulation of BP and subsequent hypertension in mature offspring.…”

Modern Recommendations of Salt Restriction - Based on Facts or Fiction?

“…In 1986 it was shown, that pregnant women change their sense of taste in favor of more salty solutions [12]. So it is not surprising that studies found salt restriction in animals and humans to be causal for retardation of fetal growth, leading to low birth weight and the underdevelopment of cardiovascular organs [13]. Hyunwoo et al examined the relation between salt restriction and insulin resistance, and found a positive association in at least 9 out of 25 studies, with very heterogeneous designs, indicating potential effects of low sodium diets on insulin resistance [14].…”