How Can We Overcome the Biological Inertia of Past Deprivation? Anthropological Perspectives on the Developmental Origins of Adult Health

Due in large part to work by David Barker and his colleagues, it is now widely accepted that prenatal nutrition modifies early development, and in so doing, influences adult biology and risk of disease. Much of this research has emphasized the limited capacity of the mother’s body to buffer the fetus from stressors which may impair early development and lead to long-term health deficits. Developmental impairment may help explain some of the relationships observed between birth size and adult health. However, many biological responses initiated in utero are not due to damage but instead reflect regulatory changes in the body’s metabolic or biological priorities. Some of these developmental sensitivities may have evolved to allow a fetus to use maternal cues to adjust biological settings in anticipation of postnatal environmental conditions. This hypothesis is supported by evidence that fetal ­nutrition is buffered against short-term fluctuations in maternal intake during pregnancy, while it shows sensitivity to a mother’s lifelong nutritional experience. By calibrating fetal nutrition to the mother’s average nutritional experiences, maternal metabolism could provide offspring with a reliable estimate of nutritional conditions likely to be experienced in the future. In humans, maternal buffering of fetal nutrition is predicted to limit the deleterious impact of nutritional stress experienced by the mother during pregnancy while also attenuating the health benefits of short-term pregnancy supplements. Designing interventions that mimic sustained improvement in environmental conditions may therefore be needed to optimize health in future generations.