Low birthweight and subsequent obesity in Japan

Gluckman, Peter D., Seng, Chong Y., Fukuoka, Hideoki, Beedle, Alan S. and Hanson, Mark A. (2007) Low birthweight and subsequent obesity in Japan. The Lancet, 369 (9567), 1081-1082. (doi:10.1016/S0140-6736(07)60524-8).

Abstract

The Lancet's World Report (Feb 10, p 451)1 rightly highlights the growing epidemic of obesity in Japan—a pattern that is also seen in other Asian countries and which might be of concern for future patterns of disease, given that susceptibility to the metabolic consequences of obesity seems to be higher in some Asian populations. There can be no doubt that this increasing prevalence of obesity is driven by changing patterns of nutrition and exercise, but there might also be other factors worthy of consideration.
We have suggested that a mismatch between intrauterine constraint, arising from small maternal stature and suboptimum fetal nutrition, and a nutritionally rich postnatal environment might explain the high levels of metabolic compromise seen in some developing populations.2 Observations of social trends in Japan suggest that such a mismatch might also occur there.
In Japan, birthweight has fallen rapidly (figure).3 and 4 This has been associated with a reduction in family size, increased maternal smoking, decreased maternal prepregnancy body-mass index resulting from dieting, and aggressive management of weight gain in pregnancy (mean weight gain in pregnancy has fallen by 2 kg in the past two decades, largely as a result of a zealous and unsupported obstetric belief that reduced weight gain is protective against pre-eclampsia5). The reduction in birthweight of more than 150 g represents a significant increase in maternal constraint and much reduced fetal nutrition. Thus if the developmental mismatch pathway has a role in the development of obesity in childhood and increases the risk of metabolic compromise,2 PD Gluckman and MA Hanson, Living with the past: evolution, development, and patterns of disease, Science 305(2004), pp. 1733–1736. Full Text via CrossRef | View Record in Scopus | Cited By in Scopus (282)2 then the developmental component is another factor in Japan's obesity epidemic and a further point for intervention. Japan's next 10-year public-health plans might have to include nutritional recommendations for pregnant women.

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Contributors

Author: Mark A. Hanson

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