One of the greatest researchers of
our time has died. David J.P. Barker, M.D., died suddenly on August 26,
2013. He lectured and wrote exclusively on nutrition in the womb and the
lifelong consequences of maternal nutrition.
Among his many titles and honors were professorships at Southampton
University in England and Oregon Health and Science University in Portland. He
was Director, MRC Environmental Unit at Southampton and Professor of
Cardiovascular Medicine at OHSU. Barker’s awards included
the Royal Society Wellcome Gold Medal, Danone International
Nutrition Award, the Prince Mahidol Prize, the Fondation Ipsen Award and the
Richard Doll Prize.Barker effectively started an entire
field of research on the developmental
origins of health and disease [DOHaD].
He posited the initially controversial but now widely accepted
idea that common chronic illnesses such as cancer, cardiovascular disease and
diabetes result not always from bad genes and an unhealthy adult lifestyle, but
from poor intrauterine and early postnatal health.
The Barker hypothesis or fetal
origins hypothesis is far-reaching, especially in area of aging and public
policy. It has led to a new understanding that chronic adult diseases are
"programmed" by malnutrition in the womb. The
environment of the fetus and infant – determined by the mother's nutrition
and the baby's exposure to infection after birth – determines the pathologies
of later life.
Barker was an epidemiologist who
found that common chronic diseases later in life result from poor nutrition in
the womb. He studied the Helsinki Birth Cohort which comprises
20,000 men and women born in the city during 1924-44. The mothers and
children have been followed throughout their lives and there is detailed
information about their early growth and development through adulthood and old
age. He found that chronic disease derives more from nutrition in the
early years of life than from pure genetic predisposition. This insight
led Barker to correlate low birth weight with heart disease, hypertension,
stroke, and type 2 diabetes [DMII].
He
described the fetal supply line: The supply of nutrients from mother to fetus are influenced
by her BMI, nutrient stores, food consumption, and transport of nutrients to
placenta and fetus. As Barker explained it, in the Western world, mothers
are either overweight or excessively thin and thus, the placenta fails to
transfer adequate nutrients from mother to fetus.
Barker also found from the longitudinal Helsinki cohort that
premature babies are predisposed to insulin resistance, glucose intolerance,
and hypertension (Glickman et al. 2008). This has far-reaching
consequences, especially the impact of teen pregnancy on predisposition of
chronic diseases. When teens are growing and developing, the fetal supply line provides nutrients to
the growing mother instead of the baby. Maternal undernutrition restricts
the growth of both fetus and placenta, yet mild undernutrition leads to a
larger placenta. This means that the nutrition is going to the placenta
and not the baby, resulting in undernourishment and predisposition of diseases
later in life. “Cardiovascular
disease and non-insulin-dependent diabetes originate through adaptations that
the fetus makes when it is undernourished… and the adaptations, which include
slowing of growth, permanently change the structure and function of the body”
(Barker, 2011).
Sources:
Barker, D.J.P. (1999) Early growth and
cardiovascular disease. Archives of Disease in Childhood: The Journal of the
Royal College of Paediatrics and Child Health, 80. 305–310.
Barker, D.J.P. (2001). The
malnourished baby and infant. British
Medical Bulletin, 60. 69–88.
Barker, D.J.P. (November 23, 2008). The Developmental Origins of Longevity.
Paper presented at the sixty-first annual meeting for the Gerontological
Society of America for the Ipsen Foundation Longevity Prize, Washington, DC.
Gluckman, P.D., (2008). Mechanisms of
disease: Effect of in utero and early life conditions on adult health and
disease. The New England Journal of Medicine, 359(1).
Ipsen Foundation. (November 23, 2008).
Brochure for the Presidential Symposium at the Gerontological Society of
America. Lectures from the laureates David J. P. Barker and Gerald E. McClearn
(November 23).
