Strategies to reduce non-communicable diseases in the offspring: negative and positivein uteroprogramming

Abstract

Non-communicable diseases (NCDs) are a major problem as they are the leading cause of death and represent a substantial economic cost. The 'Developmental Origins of Health and Disease Hypothesis' proposes that adverse stimuli at different life stages can increase the predisposition to these diseases. In fact, adverse in utero programming is a major origin of these diseases due to the high malleability of embryonic development. This review provides a comprehensive analysis of the scientific literature on in utero programming and NCDs highlighting potential medical strategies to prevent these diseases based upon this programming. We fully address the concept and mechanisms involved in this programming (anatomical disruptions, epigenetic modifications and microbiota alterations). We also examine the negative role of in utero programming on the increased predisposition of NCDs in the offspring, which introduces the passive medical approach that consists of avoiding adverse stimuli including an unhealthy diet and environmental chemicals. Finally, we extensively discuss active medical approaches that target the causes of NCDs and have the potential to significantly and rapidly reduce the incidence of NCDs. These approaches can be classified as direct in utero programming modifications and personalized lifestyle pregnancy programs; they could potentially provide transgenerational NCDs protection. Active strategies against NCDs constitute a promising tool for the reduction in NCDs.

“It only takes two minutes to ask”—a qualitative study with women on using the FIGO Nutrition Checklist in pregnancy

“…Optimal nutrition and weight during pregnancy has the potential to improve maternal and child health and reduce the global burden of noncommunicable diseases. 1 Many clinical practice guidelines in obstetrics and gynecology therefore recommend routine dietary and weight management counselling for all women. 2 The aim of this is to meet the nutritional requirements for a healthy pregnancy, manage gestational weight gain, and prevent pregnancy complications.…”

Stressful life events, the incidence of infertility, and the moderating effect of maternal responsiveness: a longitudinal study

“…Our finding is in line with evidence that the quality of parental interactions can mitigate or exacerbate the biologic response to stress across the life course, [28][29][30][31][32][33] thus suggesting another window for positive programing to mitigate harms of stressors that could have later life influences, as demonstrated by other studies. 35 The association between number of SLEs and risk of infertility is supported by evidence that SLEs increase allostatic load, an indicator of biologic "wear and tear" on the body. 14 Chronic wear and tear can affect regulation of the stress response and increase inflammation and dysregulation of the immune system to negatively impact health.…”

“…[32][33][34] Among children exposed to adversity, those with high parental responsiveness have longer telomeres than those with low parental responsiveness, again indicating a protective effect against stress. 29 Thus, we believe that the buffering effect of maternal responsiveness may positively program the same biologic pathway as that linking SLEs to infertility 35 and consider whether early life exposure to maternal responsiveness moderates the association between early life stress and infertility.…”

Micronutrients in Multiple Pregnancies—The Knowns and Unknowns: A Systematic Review

“…Moreover, increasing attention has recently been paid to the impact of fetal and early nutrition on the risk of noncommunicable diseases, such as cardiovascular diseases, diabetes, obesity or even neurocognitive impairments later in life [9]. For almost two decades, scientists around the world have been studying the so-called programming phenomenon related to the onset of such diseases [1,[9][10][11][12].…”