The seed is sown in utero: Maternal Nutrition and Its Influence on the Health of the Next Generation

Legacy of David Barker

In the 1980’s the British doctor and epidemiologist David Barker tried to explain an apparent contradiction: as British prosperity increased, so did heart disease. Yet geographically, the highest rates of heart disease were found in the poorest places in Britain. Barker concluded in his landmark study that rather than smoking, dietary fat or some other lifestyle cause, the factor most predictive of whether an individual would develop premature heart disease (before the age of 65) was birth weight.

His follow-up research supported and expanded this finding, concluding that babies born small to malnourished mothers are at a higher risk of hypertension and coronary heart disease, as well as type 2 diabetes later in life.


How the first nine months shapes the rest of your life

Over the past 30 years, Barker’s work has been reproduced and broadened.  The relationships between early life nutrition and disease risk in later life observed in epide­miological studies have been supported by experimental studies using a variety of animal models. While the theory originally focused on how maternal and foetal malnutrition contributes to heart and metabolic conditions, newer studies have identified additional diseases such as cancer, heart disease, allergies, asthma, autoimmune disease, diabetes, obesity, mental illness and degenerative conditions like arthritis, osteoporosis, dementia and Alzheimer’s that can be of foetal origin.

It has been shown that manipulation of nutrition in the period extending from conception to infancy can result in permanent changes in body structure, function, and metabolism in the offspring. The associations may reflect “developmental plastic responses,” whereby the developing foetus adapts to nutritional and hormonal signals from the mother in utero and adjusts its developmental trajectory to produce a phenotype that is matched to the predicted postnatal environment. When there is a mismatch between the anticipated and the actual environment experienced in later life, disease risk increases. Furthermore, it has been demonstrated that the long-term consequences of adverse nutritional conditions during early development may not be lim­ited to one generation, but may lead to poor health in the succeeding generations.


Developmental Programming

Developing organs and physiological systems may be permanently changed in response to reduced availability of nutrients. These acute adaptations, although advantageous for short-term survival, may be detrimental for health in later life if nutrition is more abundant in the postnatal environment than in the prenatal environment. The concept of the “thrifty phenotype,” based on embryonic and foetal adaptive responses to a sub opti­mal intrauterine nutritional environment, which have permanent adverse consequences, is consistent with the biological phenomenon known as “programming,” championed by Lucas in 1991. This was defined as a process whereby a stimulus or hindrance acting at a “critical” or “sensitive” period of devel­opment results in a permanent change in the structure and function of the organism.


The seed is sown in utero

Recent research suggests the most powerful influence on lifelong health is the mother’s nutritional status during (and even before) her pregnancy. In fact, some researchers now believe the 9 months of pregnancy are the most consequential period of our lives, permanently influencing the wiring of the brain and the function of organs like the heart, liver and pancreas. They also suggest that the conditions we encounter in utero shape everything from our susceptibility to disease, to our appetite and metabolism and our intelligence and temperament. You are only as healthy as your mother’s womb

The nutritional conditions in the womb start before conception

Having established that the nutritional environment of a mother’s womb affects the baby’s health not only at birth but for the rest of his or her life, this leads to the obvious conclusion that proper maternal nutrition is crucial for the lifelong health of her offspring. But it should also be obvious that the mother’s diet in the months and even years leading up to conception is also important.

This is why traditional cultures have sacred fertility foods they feed to mothers-to-be and even fathers-to-be. These include nutrient-dense foods like fish eggs, liver, bone marrow, egg yolks and other animal fats.

Unfortunately, this traditional wisdom has been largely lost in the modern world and misinformation and misguidance prevails as a mother’s diet and lifestyle prior to conception and during pregnancy may be one of the most important factors in determining the lifelong health of her baby.




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Agnes Ryu

Agnes Ryu

Dr. Ryu is a clinician and biochemist specializing in integrative medicine. Her clinical interests include fertility, hormones, metabolism, healthy ageing, menopause, and natural breast cancer care. As an integrative practitioner, Dr. Ryu aims to uncover the root causes of health issues and strives to empower patients with the knowledge and tools to take charge of their own health.

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