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Foetal programming is a theory that suggests that the environment of the foetus during development affects their disease risk later in life.

The three main routes of this programming are through maternal environment causing:

• changes in the development that leads to greater disease risk.
• genetic changes which alter disease risk.
• epigenetic changes which alters disease risk of not only their child but their children’s children - i.e. after famine the grandchildren of women pregnant are born smaller than expected even with the return of normal nutrition.

These maternal environmental changes can be through nutritional changes, hormonal changes or exposure to toxins.

History

Dutch Famine 1944-45

In 1944-45 a German blockade led to a lack of food supplies in the Netherlands, which later became known as the Dutch Famine. This famine meant that the population became severely malnourished, including women in various stages of pregnancy.

The Dutch Famine Birth Cohort Study looked at the effects of this lack of nutrition on the children born during or after this famine. Over the course of their lifetime it showed that they were at greater risk of diabetes, cardiovascular disease, obesity and other non-communicable diseases.

Barker Hypothesis

In the 1980’s David Barker began research on this topic. The Barker Hypothesis, or Thrifty phenotype, is the basis for much of the research on foetal programming. This hypothesis stated that if the foetus is exposed to low nutrition it will adapt to that environment. Nutrients are diverted to the heart, brain and other essential organs. The body also undergoes metabolic alterations that allow for survival with low nutrition but cause problems in normal or high nutrition. This leads to increased risk of developing metabolic syndrome.