Treating "Diabesity": Targeting Prenatal, Childhood Risk Factors May Be Best Strategy

Main Category: Diabetes
Article Date: 11 Jul 2008 - 0:00 PDT

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The best time to intervene to prevent obesity, diabetes, and related disorders is from the moment of conception to puberty, experts argue in a new electronic briefing published by the New York Academy of Sciences (www.nyas.org/diabesity).

"Many of us feel we're not going to cure adult obesity, but if we can learn the antecedents, we may be able to prevent it," says Barry Levin, MD, of the University of Medicine and Dentistry of New Jersey, who organized a recent Academy symposium on the subject along with John Kral, MD, PhD, of SUNY Downstate Medical College and Gerard P. Smith, MD, of Weill Cornell Medical College.

More than 50 genes probably play a role in obesity, but genes only account for about 60% to 70% of the problem, Levin pointed out. Other factors explored in the eBriefing include maternal weight and insulin status at the time of conception, the child's nutrition shortly after birth, stress in early childhood, and family eating habits that can lead to overweight.

Although the precise mechanisms by which these factors cause obesity are still unknown, it's clear that parents play a role in conferring risk to their children, the experts say. Thus, preventing the spread of obesity and diabetes means finding ways to target not only specific genes, but also the factors that influence gene activity during prenatal and childhood development.

Solving this problem is an important challenge. A new report by the US Centers for Disease Control and Prevention shows that 24 million people in the United States now have diabetes-approximately 8% of the nation's population. This is an increase of more than 3 million in two years-and most cases are linked to obesity, poor diet, and lack of exercise.

The Academy's eBriefing offers new insights into the genetic and epigenetic causes of obesity and diabetes in people, possible intervention strategies, and a look at animal models that are helping researchers understand the underlying mechanisms of these conditions. It features a meeting report with highlights and take-home messages from the following experts, as well as several video interviews and slide/audio presentations of their lectures.

Robert A. Waterland, PhD (Baylor College of Medicine) explains epigenetics and its role in obesity and diabetes.

Rudolph L. Leibel, MD (Columbia University) describes genetic modifiers of obesity and diabetes.

Patrick M. Catalano, MD (Case Western Reserve University) characterizes short- and long-term effects of the maternal in-utero environment on the offspring.

Robert C. Whitaker, MD, MPH (Temple University) proposes clinical strategies to help break the cycle of obesity "transmission" from one generation to the next.

John G. Kral, MD, PhD (SUNY Downstate Medical Center) describes studies showing that offspring of obese mothers who underwent bariatric surgery were more likely to be normal weight and less likely to become obese.

Andreas Plagemann, MD (University of Medicine Berlin) emphasizes the value of breastfeeding in reducing child health risks.

Tanja V.E. Kral, PhD (University of Pennsylvania) discusses the importance of creating a low-stress family environment to mitigate the genetic and epigenetic propensities of some children to eat in the absence of hunger.

Sebastien G. Bouret, PhD (University of Southern California) describes mechanisms of perinatal programming of neural circuits that regulate energy homeostasis.

Barry E. Levin, MD (University of Medicine and Dentistry of New Jersey) describes the results of studies with rat models of obesity.

Peter W. Nathanielsz, MD, PhD, ScD (University of Texas Health Science Center) looks at the effects of maternal nutrient restriction on fetal development.

Jeremy D. Coplan, MD (SUNY Downstate Medical Center) shows evidence that adversity in early life can have lifelong consequences associated with elevations in body mass index and plasma cholesterol.

About the New York Academy of Sciences

Founded in 1817, the New York Academy of Sciences (NYAS) is an independent, nonprofit organization committed to advancing science, technology, and society worldwide. With more than 25,000 members in 140 countries, NYAS is creating a global community of science for the benefit of humanity. NYAS's core mission is to advance scientific knowledge, positively impact the major global challenges of society with science-based solutions, and increase the number of scientifically informed individuals in society at large.

New York Academy of Sciences

About Academy eBriefings

New York Academy of Sciences eBriefings are an integral part of the Academy's scientific programming, documenting and extending the reach of our symposia and conferences in many cutting-edge fields in the life sciences, physical sciences, and engineering.

Academy eBriefings