Chiara Frazzoli and Alberto Mantovani
The risk of developing metabolic disorders in adult life is influenced by environmental factors that operate during pre- and early postnatal development. In fact, even thoughmuch of the rise in obesity pandemic is attributed to lifestyle factors ashyper-caloric/nutritionally poor diet and sedentary life, other additional riskfactors have been proposed. The ‘developmental programming’ is a process during which a stimulus in utero or in the early life stages may establish a permanent response leading to enhanced risk of developing adulthood disease. The ‘Thrifty Phenotype’ hypothesis explains the role of insufficient in utero nutrition as strong programming stimulus in later development of Type 2 diabetes. The ‘Predictive Adaptive Response’ hypothesis proposes that the degree of mismatch between the pre- and postnatal environments is a key determinant in abnormal programming and subsequent disease outcome. It has been suggested that neuroendocrine development during fetal life may be based on predictions about postnatal environmental conditions: following this hypothesis, interaction between the prenatal undernutrition and postnatal high-fat nutrition amplifies the propensity towards diet-induced obesity (Ikenasio-Thorpe BA, Breier BH, Vickers MH, Fraser M. Prenatal influences on susceptibility to diet-induced obesity are mediated by altered neuroendocrine gene expression. J Endocrinol. 2007; 193: 31-7).