By Casey Lazonick, Alternet
Can obesity start in the womb? According to recent work by scientists in Germany, the answer may be yes. Researchers at the Charite Hospital in Berlin found that babies with a high weight (over 8 pounds) had double the chances of suffering obesity as their normal-weight counterparts.
This insight is shifting previous beliefs that emphasized genetic causes such as overweight parents or other family members. Specifically, the new view claims that child obesity is primarily the result of the mother’s weight and food preferences during pregnancy. Dietician Bonnie Modungo, a specialist in weight management, notes an increasing trend in which “ pregnant women are heavier, have higher blood glucose levels, and grow bigger babies.” Modugno adds that the issue is the amount of fat stores the baby has in her organs and tissue.
What’s happening in the womb?
Over the past 10 years, scientists in New Zealand, Canada, the U.S. and the U.K. have studied obesity and epigenetics to attempt to understand the connection between prenatal nutrition and obesity. They have found that what a mother eats during pregnancy directly correlates to the infant’s food preferences throughout the course of his or her life. Simon Langley-Evans of the University of Nottingham studied the fetal hypothalamus, which is developed during the first trimester of pregnancy. In his study, pregnant rats were fed either a controlled diet of rat chow or a combination of rat chow and junk foods (e.g., doughnuts, cakes, pies, potato chips, fried foods). The offspring of the rats fed unhealthy foods ate excessively more junk foods, while both groups ate the same amount of rat chow. He then did research to see if these same results applied to humans. They did.
According to the Centers for Disease Control and Prevention (CDC), a person’s appetite appears to be set before and directly after birth. When the mother ingests food, the fetus detects the flavors through a sense of smell in the amniotic fluid in which it floats.
Although these senses are minimal, the fetus forms preferences in the hypothalamus. This phenomenon creates a set point of satiety, meaning that as a child and adult the offspring will not feel satisfied until these preferences are met. When pregnant women eat a diet high in fat and sugar and low in protein, the theory goes, infants are born at higher birth weights and are pre-wired to have higher energy needs, to hoard calories and to crave high fat and high sugar foods. What follows is obesity in childhood and adulthood.
It has also been shown that high levels of energy consumption during pregnancy can alter the genetic code in children, causing them to have increased energy needs into adulthood. This makes it difficult for children to control weight gain and ultimately leads to obesity. These studies also cover the case of breast milk: Infants can taste the foods consumed by the mother through the breast milk, once again reinforcing a preference to what their mother eats and drinks.
Mothers confused, low-income babies at risk
For a pregnant woman, knowing what to eat and drink during pregnancy is a challenge. There a thousand different views on what is acceptable, and a simple Google search can throw you in 20 different directions. For example, pregnant mothers are often warned about alcohol consumption, and even refused a glass of wine in restaurants, and yet a report in Scientific American shows that a glass of wine a day does no harm. Then there’s the question of fish. How much mercury is safe? And how many grams of fat per day is optimal? To strive for perfection with prenatal nutrition is near enough impossible, but the issue behind obesity in the womb is often traced back to the fact that many mothers in America do not have adequate healthcare or not enough access to healthy foods.
In the state of New York, 15 percent of women experience either late initiation to prenatal care or do not get any at all. In New Mexico, the number of women who get late initiation to prenatal care or none whatever is 39.9 percent. This makes it nearly impossible for new mothers to know which decisions are the best ones.
There are several different views on how to combat obesity that may start in the womb, but many researchers and writers agree upon a few key points. Eating a high-protein, lowfat diet during pregnancy has been shown to result in a lower risk of obesity in the child. Good sources of protein include almonds, salmon, chicken or turkey breasts and lentils. Fruits, vegetables and whole grains are encouraged and processed foods are not recommended. During pregnancy, a woman may need only 300 calories more than normal in order to have adequate nutrition for the fetus (forget the whole “eating for two” theory).
But what if you can’t get access to either sound advice or healthy food?
Obesity prevalence in low-income communities is growing twice as fast as obesity prevalence in high-income communities. A study performed at Simmons College in Massachusetts has shown that children born to obese mothers with low incomes have a 34 percent increased risk of becoming obese themselves. Genetics alone doesn’t explain this: the higher risk is thought to stem partly from the food choices available to low-income families.
Maintaining a well-balanced diet for some is more time consuming than getting fast food or ready meals, and research has shown that the only places to find fresh produce and healthy food options in low-income communities are in grocery stores, which are scarce. One study shows that there are half the number of chain grocery stores in predominantly black communities compared to predominantly white communities, while Hispanic communities have only one-third of the number of grocery stores in close proximity. Three studies found a reduced risk of obesity in areas with more supermarkets, while two studies found a link between easy access to convenience stores and an increased risk of obesity. The lack of access makes it hard for mothers in these areas to eat healthfully.
Obesity that starts before birth is a scary thought. As Robert Lustig, a professor of pediatrics states, “we can no longer judge obesity as a disease for gluttons and sloths” or some type of unfortunate failure or lack of self constraint. The causes of obesity are complex, and often begin before a person has the ability to make choices.
This article was written by Casey Lazonick and originally published in Alternet on May 28, 2013.