Over The Horizon

Heart Disease Risk

Coronary heart disease and strokes, together with a number of associated conditions, may originate during foetal development and early infancy, according to a paper presented at a New Zealand nutrition conference by Professor David Barker of Southampton General Hospital.

Studies of variations in rates of heart disease between different places in England revealed that the differences in adult lifestyles between those places were not enough to explain the differences in heart disease. Infant mortality rates in a particular place at a given time, however, were strongly correlated with rates of death from heart disease in people born at the same time and place.

Other studies indicated that, in general, the higher a person's weight at one year, the less likely they were to eventually die from heart disease, or to suffer from high blood pressure or non-insulin dependent diabetes. High weight at one year was not associated with adult obesity, being more related to adult height.

These and other results suggest that under-nutrition in early life may lead to a risk of heart disease as an adult, through a phenomenon called programming. Many organs and systems have critical times, sometimes quite brief, where they mature during rapid periods of foetal or infant growth. Inadequate nutrition during these periods will lead to a permanent disability of some sort. For example, kidneys mature in the last few weeks before birth. After this time, few new kidney cells are produced, so a lack of nutrients in those few weeks can cause permanent impairment of kidney function. The researchers believe that something of this sort may affect parts of the metabolism that relate to disorders such as heart disease.

Barker notes that adult environments are, naturally, also important in the development of heart disease, but that infancy-related factors may explain why known adult risk factors are not good predictors of which individuals will actually suffer heart disease.