Does Obesity and Diabetes Begin in the Womb?

Diabetes, Obesity, Pregnancy

Several recent studies point to the possible origination of both obesity and diabetes in the womb.

An article in the LA Times last year had a quote from Beverly Muhlhausler, a researcher at the University of South Australia and an authority on fetal diet and adult disease:

“What research is now showing is that consuming an excessive amount of high-fat, high-sugar foods during pregnancy can alter the development of the baby in such a way that predisposes that individual to becoming obese later in life.”

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If we continue to wait until middle age to treat societal health issues like obesity and diabetes, we may not ever address the causes, which might already be treatable by changing the mother’s diet or addressing maternal weight gain.

1. Mother’s weight gain during pregnancy is linked to childhood obesity.

A new study of 12,000 adolescents aged 9-14 and their mothers concludes that excess weight gain by mothers during pregnancy is directly associated with the risk of obesity in adolescence. The researchers found that the high birth-weight risk was increased dramatically with a higher weight gain in the mother (35% for a gain of 45 pounds or more).

The study came from participants in the Growing Up Today Study, and looked at the correlation between the mother’s weight gain and their child’s birth weight and body-mass index (BMI) later in life, specifically adolescents. The abstract is here: Maternal gestational weight gain and offspring weight in adolescence.

2. Maternal gestational diabetes may increase the risk of children being overweight in adolescence.

Another study looks at the link between gestational diabetes and obesity in offspring. “Gestational diabetes mellitus (GDM) creates a metabolically altered fetal environment which is associated with high birth-weight, also associated with later obesity.” The study concludes:

“Birth weight was directly related to risk of overweight 9 to 14 years later. GDM, itself a determinant of higher birth weight, was also associated with increased risk of adolescent overweight, but much of this association was explained by the confounding influence of maternal BMI, perhaps owing to a combination of pre- and postnatal environmental factors as well as genetic inheritance. Thus, GDM is a risk marker for offspring obesity, but to what extent it exerts a causal influence remains the subject of additional research. Such research is vital, because rising rates of obesity in youth portend an increase in GDM, potentially resulting in a vicious cycle of increasing obesity for generations to come.”

Full text is here: Maternal Gestational Diabetes, Birth Weight, and Adolescent Obesity

3. Maternal weight gain is linked to hyperinsulinemia.

An Arizona State University study investigated some conditions during pregnancy that may impact insulin metabolism in offspring. The pilot study looked at associations between maternal weight gain and infant insulin concentrations, or hyperinsulinemia. Hyperinsulinemia is a condition of excess levels of circulating insulin in the blood. It isn’t diabetes, but is often associated with type 2 Diabetes.

“These data show that maternal weight gain predicted infant insulin concentrations. Our preliminary data support the contention that gestational weight gain should be carefully considered in overweight populations at high risk for diabetes. Controlling weight gain during obese pregnancies may be advantageous and more studies of this nature are warranted.”

Read the results in Diabetes Care journal: Maternal Weight Gain Is Associated With Infant Insulin Concentrations During the 1st Year of Life

For those working with pregnant mothers, education is paramount. Muhlhausler says, “One of my dreams as a researcher is to be able to get the message out that what you eat during pregnancy has a huge impact on your child’s development and long-term health prospects.”

Image: aldenchadwick at Flickr under Creative Commons License

Comments

  1. Hi,

    I’m a registered dietitian and I just have to clear the air about this post.

    I am concerned that this post is portraying a trend that we are seeing all too often with pregnant moms these days. More often, moms are AFRAID of gaining ANY weight. They are happy when they don’t gain weight with comments like “made it through my first trimester and I haven’t gained any weight” and “I can still eat as light as I did before getting pregnant.” These aren’t eating disorder moms either.

    The bottom line is gaining weight in pregnancy is needed for a healthy baby for everyone. There are some docs who **may** recommend maintaining weight during pregnancy when their patients are already obese – BMI over 30, usually over 35. But others recommend some minimal weight gain. It is all personal so pregnant women should see their doctor AND a dietitian to get the right information about how much weight they should gain for them. Dietitians can help mom through a healthy pregnancy gaining appropriate weight. Moms also shouldn’t worry because breastfeeding helps the post-baby pounds melt away. Breastfeeding moms have a “furnace” for a body (high metabolism).

    In regards to the research…

    1. would love to know what the BMIs of the moms were and their kids. Underweight moms may need to gain 45# during pregnancy. I doubt an underweight mom who gained 45# would have an obese kid.

    2. GDM has been “linked” to obesity for some time. It doesn’t mean “causes”.

    Bottom line on research, there will always be more needed. Pregnant moms should take advantage of real health professionals.

    Thanks for letting me share!

  2. Rebecca, I was underweight when I started both of my pregnancies. I gained 55 pounds with my first and 45 pounds with my second. My midwives were very supportive and said my body would do what it needed to do. I only ate healthy food, so I think the difference with weight gain is the kind of food mothers eat, like McDonalds, etc. I did see a dietitian, because my midwives were concerned I could even gain weight, since I lost 10 pounds during my first trimester (I was very sick). Neither of my kids are overweight. My daughter was quite the chunky monkey breastfed babe, but as soon as she started walking, she slimmed down.

  3. This article concerns me as well as I did gain a lot of weight when pregnant, 67lbs in fact — and I started out at barely 100lbs. I had never been able to gain weight despite my best efforts, until I became pregnant. I ate mostly healthy foods, as I always have, but did start enjoying baked goods, which I had detested before. Now, almost a year later, the weight has just shed all by itself. My baby is very thin and tall, just like her father and I naturally are. She was born at 6lbs 10oz. I really hope she doesn’t get diabetes or become obese, which can threaten her health. Though I wouldn’t mind if she chubbed up a bit more :)

  4. I think it’s ridiculous for OB’s to insist that thin moms gain 45 lbs during pregnancy. The first OB I saw during my pregnancy with my oldest gave me a big lecture about that, and it was one of the reasons why I switched to a different doctor. I ended up gaining 29 lbs and had a perfectly healthy baby. With my 2nd, I gained 30 and again had a perfectly healthy baby.

    I’m 37 weeks with #3 and have gained 27 lbs so once again I’ll probably end up gaining around 30 lbs total.

    While a 45 lbs weight gain may not be unhealthy for a thin mom during pregnancy, I definitely don’t think she really *NEEDS* to gain that much.

  5. Oh, and the breastfeeding helping weight loss thing is a myth. My oldest was physically unable to nurse and pumping alone wasn’t enough to keep my milk supply from drying up at 6 wks post-partum. The pregnancy weight came off very quickly.

    My 2nd I EBF until he self-weaned a few weeks before his 1st birthday. The pregnancy weight came off a LOT more slowly that time around. I’m still glad that I was able to BF, but was disappointed that it hurt rather than helped when it came to getting my body back.

  6. This article concerns me as well as I did gain a lot of weight when pregnant, 67lbs in fact — and I started out at barely 100lbs. I had never been able to gain weight despite my best efforts, until I became pregnant. I ate mostly healthy foods, as I always have, but did start enjoying baked goods, which I had detested before. Now, almost a year later, the weight has just shed all by itself. My baby is very thin and tall, just like her father and I naturally are. She was born at 6lbs 10oz. I really hope she doesn’t get diabetes or become obese, which can threaten her health. Though I wouldn’t mind if she chubbed up a bit more :)

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