Maternal nutrition and the programming of obesity: The brain

Abstract

The increasing incidence of obesity in the developed and developing world in the last decade has led to a need to define our understanding of the physiological mechanisms which can predispose individuals to weight gain in infancy, childhood and adulthood. There is now a considerable body of evidence which has shown that the pathway to obesity may begin very early in life, and that exposure to an inappropriate level of nutrition during prenatal and/or early postnatal development can predispose individuals to obesity in later life The brain is at the heart of the regulation of appetite and food preferences, and it is increasingly being recognized that the development of central appetitive structures is acutely sensitive to the nutritional environment both before and immediately after birth. This review will summarize the body of work which has highlighted the critical role of the brain in the early origins of obesity and presents some perspectives as to the potential application of these research findings in the clinical setting.

Keywords: appetite; fetal programming; leptin; neuropeptides; obesity.

Figure 1

A schematic overview of the appetite regulatory pathways in the adult hypothalamus. (From ref. with permission.)

Figure 2

Autoradiographs depicting the distribution of POMC mRNA expression in the fetal ARC in saline infused (A) and glucose infused (B) fetuses at 140 ± 1 d gestation (term ∼150 d gestation). (C) The effect of glucose infusion on the expression of POMC mRNA in the fetal arcuate nucleus. * denotes p < 0.05 compared to the saline infused fetuses. ARC: arcuate nucleus, 3V: third ventricle.

Figure 3

Autroradiographs depicting typical patterns of OBRb expression in the fetal sheep at (A) 134 d gestation (B) 141 d gestation and (C) 30 d of postnatal age. (D) Graph depicting the ratio of expression of OBRb in the arcuate nucleus (ARC) and ventromedial hypothalamus (VMH) at 134 d gestation, 141 d gestation and 30 d of postnatal age. Different letters denote significant differences between age groups p < 0.05. ARC: arcuate nucleus, VMN: ventromedial hypothalamus, 3V: third ventricle.

Figure 4

Overview of our current working hypothesis on the pathway through which maternal overnutrition results in the programming of obesity in postnatal life.