title: A critical review: early life nutrition and prenatal programming for adult disease.
abstract: OBJECTIVE
  To present the evidence in relation to early life nutrition and foetal programming for adult disease.
  
  
  BACKGROUND
  Epigenetics is a new and growing area of study investigating the impact of the intrauterine environment on the lifelong health of individuals.
  
  
  METHODS
  Discursive paper.
  
  
  METHODS
  Searches were conducted in a range of electronic health databases. Hand searches located additional articles for review. Maternal search terms included: pregnancy; nutrition; diet; obesity; over nutrition; under nutrition. Offspring related search terms included: macrosomia; intrauterine growth restriction; epigenetics; foetal programming; childhood obesity; adolescent obesity; adolescent type 2 diabetes.
  
  
  CONCLUSIONS
  Results indicate that foetal programming for adult disease occurs in response to particular insults during vulnerable developmental periods. Four main areas of foetal exposure were identified in this review: (1) under nutrition; (2) over nutrition; (3) gestational diabetes mellitus; and (4) infant catch-up growth. Numerous studies also described the trans-generational nature of foetal programming.
  
  
  CONCLUSIONS
  Overall, foetal exposure to excess or insufficient nutrition during vulnerable developmental periods appears to result in a lifelong predisposition to obesity and adult disease, such as type 2 diabetes and cardiac disease. For the infant who has been undernourished during early life, a predisposition to renal disease also occurs.
  
  
  CONCLUSIONS
  Pregnancy is a time when women are engaged in health systems and are receptive to health messages. These factors suggest that pregnancy may be an optimal time for dietary education and intervention. There is a particular need for education on healthy diet and for interventions which aim to limit over consumption of calories.
authors.affiliation: College of Health and Biomedicine, Nursing and Midwifery, St Alban's Campus, Victoria University, Melbourne, Vic., Australia.
authors.forename: Mary
authors.initials: M
authors.lastname: Carolan-Olah
authors.affiliation: Department of Public Health Sciences, College of Health Sciences, The University of Texas at El Paso, El Paso, TX, USA.
authors.forename: Maria
authors.initials: M
authors.lastname: Duarte-Gardea
authors.affiliation: Department of Psychology, College of Health Sciences, The University of Texas at El Paso, El Paso, TX, USA.
authors.forename: Julia
authors.initials: J
authors.lastname: Lechuga
mesh_terms: D000328:Adult; D016640:Diabetes, Gestational / Q000209:etiology*; D044127:Epigenesis, Genetic; D005260:Female; D005317:Fetal Growth Retardation / Q000209:etiology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009748:Nutrition Disorders / Q000150:complications*; D009752:Nutritional Status; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000209:etiology*
keywords: epigenetics; foetal programming; metabolic disease; obesity