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).

Some pollutants may indeed contribute to alter developmental programming. Dietary exposure to widespread pollutants (Dioxins and dioxin-like PCBs, Arsenic, Cadmium, Bisphenol A, Organophosphate insecticides) may represent a “trigger”, i.e. a key risk factors in the increased proneness to the onset of metabolic syndrome ( Such contaminants may alter programming of body composition or development by acting, e.g., on the glucorticoid and/or thyroid axis and/or by modulating epigenetic regulation of gene expression. In most situations the levels of individual contaminants are too low to affect a healthy individual;however one has to consider the possibility of additive modes of action  as well as, most important, the unique vulnerability of the unborn child.Such exposure takes place mostly through foods containing high percentage of lipids (some kinds of fish, fatty meat, and dairy products); therefore, more targeted and up-to date controls and preventive actions could effectively contributeto public health plans against pandemic obesity.Preventive actions to reduce the chance of contamination and control/risk management interventions on specific food production chains would thus contribute to implement the “sustainable food safety” framework, ensuring protection also to next generation (Frazzoli C, Petrini C, Mantovani A. Sustainable development and next generation’s health: a long-term perspective about the consequences of today’s activities for food safety. Ann Ist Super Sanità, 2009; 45:65-75).

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Chiara Frazzoli

Alberto Mantovani

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