The developmental origins of adult disease

Authors

  • Peter D. Gluckman FRS,

    Corresponding author
    1. Liggins Institute, University of Auckland, Grafton, Private Bag 92019, Auckland, New Zealand
      Peter D. Gluckman, Liggins Institute, University of Auckland, 2–6 Park Avenue, Grafton, Private Bag 92019, Auckland, New Zealand. Tel.: +64 +9 373 7599; fax: +64 +9 373 7497; e-mail: pd.gluckman@auckland.ac.nz
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  • Mark A. Hanson DPhil,

    1. Centre for Developmental Origins of Health and Disease, University of Southampton, Princess Anne Hospital Level F (887), Southampton S016 5YA, UK
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  • Catherine Pinal PhD

    1. Liggins Institute, University of Auckland, Grafton, Private Bag 92019, Auckland, New Zealand
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Peter D. Gluckman, Liggins Institute, University of Auckland, 2–6 Park Avenue, Grafton, Private Bag 92019, Auckland, New Zealand. Tel.: +64 +9 373 7599; fax: +64 +9 373 7497; e-mail: pd.gluckman@auckland.ac.nz

Abstract

Epidemiological and clinical observations have led to the hypothesis that the risk of developing some chronic diseases in adulthood is influenced not only by genetic and adult lifestyle factors, but also by environmental factors acting in early life. These factors act through the processes of developmental plasticity and possibly epigenetic modification, and can be distinguished from developmental disruption. The concept of predictive adaptation has been developed to explain the relationship between early life events and the risk of later disease. At its base, the model suggests that a mismatch between fetal expectation of its postnatal environment and actual postnatal environment contribute to later adult disease risk. This mismatch is exacerbated, in part, by the phenomenon of ‘maternal constraint’ on fetal growth, which implicitly provides an upper limit of postnatal nutritional environment that humans have adapted for and is now frequently exceeded. These experimental, clinical and conceptual considerations have important implications for prevention and intervention in the current epidemic of childhood obesity and adult metabolic and cardiovascular disorders.

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