ABSTRACT
It has been known for decades that birth weight is a predictor of later-life diseases (Barker et al. 1989a, b). The thrifty phenotype hypothesis was presented in the early 1990s and suggests that low birth weight offspring have a higher incidence of multiple diseases later in life (Hales and Barker 1992). The developmental origins of health and disease (DOHaD) hypothesis has grown out of this and the work of many others (Gluckman and Hanson 2004; Gluckman et al. 2005). The DOHaD hypothesis suggests that fetal programming is likely playing a role in the alarming increase in obesity of children and adolescents and will result in increased diabetes, cardiovascular disease, and early death during adulthood (Gluckman and Hanson 2008; Gluckman et al. 2008). Pregnancy is a critical time for both the mother and
2.1 Developmental Programming ......................................................................... 53 2.2 Type 2 Diabetes ..............................................................................................54 2.3 Developmental Programming of Diabetes: Human Maternal Malnutrition .... 55 2.4 Developmental Programming of Diabetes: Animal Models of Maternal
Malnutrition .................................................................................................... 56 2.5 Developmental Programming of Diabetes: Maternal Obesity and
Gestational Diabetes ....................................................................................... 57 2.6 Exercise During Pregnancy: Maternal Effects in Normal Pregnancies .........60 2.7 Exercise During Pregnancy: Maternal Effects in Diabetic Pregnancies ........ 62 2.8 Exercise During Pregnancy: Effects on Offspring .........................................64 2.9 Discussion and Future Directions ...................................................................69 2.10 Conclusion ...................................................................................................... 74 Acknowledgments .................................................................................................... 74 References ................................................................................................................ 74
developing fetus. Events that occur during pregnancy can have a permanent effect on the health of the offspring. Developmental programming is a theory that the stimuli received from the intrauterine environment can result in long-term changes in an organism that can predispose or protect it from diseases later in life. It is well known that changes to the intrauterine environment caused by things such as drug use (for example, tobacco and alcohol) can cause changes in fetal development that result in physical and mental dysfunction in offspring that last a lifetime. Less studied is how maternal diet and physical activity can affect offspring, particularly offspring metabolic health. Over the past two decades, research has emerged showing that maternal diet, whether it is undernutrition or overnutrition, can alter offspring insulin sensitivity and increase offspring incidence of type 2 diabetes. This chapter will dene and discuss diabetes as well as outline developmental programming of this disease in humans and animal models. Lastly, this section will introduce the benets of exercise and the potential use of exercise during pregnancy as an intervention to positively impact offspring health.
