title: The early origins of obesity and insulin resistance: timing, programming and mechanisms.
abstract: Maternal obesity is associated with an increased risk of developing gestational diabetes mellitus and it also results in an increased risk of giving birth to a large baby with increased fat mass. Furthermore, it is also contributes to an increased risk of obesity and insulin resistance in the offspring in childhood, adolescence and adult life. It has been proposed that exposure to maternal obesity may therefore result in an 'intergenerational cycle' of obesity and insulin resistance. There is significant interest in whether exposure to maternal obesity around the time of conception alone contributes directly to poor metabolic outcomes in the offspring and whether dieting in the obese mother before pregnancy or around the time of conception has metabolic benefits for the offspring. This review focusses on experimental and clinical studies that have investigated the specific impact of exposure to maternal obesity during the periconceptional period alone or extending beyond conception on adipogenesis, lipogenesis and on insulin signalling pathways in the fat, liver and muscle of the offspring. Findings from these studies highlight the need for a better evidence base for the development of dietary interventions in obese women before pregnancy and around the time of conception to maximize the metabolic benefits and minimize the metabolic costs for the next generation.
authors.affiliation: Sansom Institute for Health Research, School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, SA, Australia.
authors.forename: L M
authors.initials: LM
authors.lastname: Nicholas
authors.affiliation: Sansom Institute for Health Research, School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, SA, Australia.
authors.forename: J L
authors.initials: JL
authors.lastname: Morrison
authors.affiliation: Sansom Institute for Health Research, School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, SA, Australia.|Discipline of Physiology, School of Molecular and Life Sciences, University of Adelaide, Adelaide, SA, Australia.
authors.forename: L
authors.initials: L
authors.lastname: Rattanatray
authors.affiliation: Sansom Institute for Health Research, School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, SA, Australia.
authors.forename: S
authors.initials: S
authors.lastname: Zhang
authors.affiliation: Department of Clinical Biochemistry, Institute of Metabolic Science-Metabolic Research Laboratories, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK.
authors.forename: S E
authors.initials: SE
authors.lastname: Ozanne
authors.affiliation: Sansom Institute for Health Research, School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, SA, Australia.|The Chancellery, University of Newcastle, Callaghan, NSW, Australia.
authors.forename: I C
authors.initials: IC
authors.lastname: McMillen
mesh_terms: D000328:Adult; D016640:Diabetes, Gestational / Q000209:etiology*; D005260:Female; D006801:Humans; D007223:Infant; D007333:Insulin Resistance; D039382:Maternal Nutritional Physiological Phenomena; D009035:Mothers; D009765:Obesity / Q000150:complications* / Q000378:metabolism / Q000503:physiopathology; D063766:Pediatric Obesity / Q000209:etiology* / Q000517:prevention & control; D011247:Pregnancy; D011248:Pregnancy Complications / Q000378:metabolism*; D011297:Prenatal Exposure Delayed Effects / Q000209:etiology* / Q000517:prevention & control; D012307:Risk Factors; D015398:Signal Transduction