Programming of childhood overweight due to perinatal overnutrition

Childhood overweight and obesity are urgent health problems with far-reaching consequences up into adulthood. Based on still poorly defined mechanisms, referred to as fetal programming, the risks of later life health problems are already determined during the earliest prenatal stages of life and appear to aggravate the overweight situation. Periconceptional maternal obesity and additional perinatal risk factors including a disproportionately high gestational weight gain, gestational diabetes and postnatal rapid weight gain in the first 2 years of life, promote the risk of developing overweight and associated metabolic disorders in childhood. Animal experimental studies provide the advantage of studying the consequences of maternal overnutrition for the offspring in a controlled setting. Adverse nutritional exposure, such as a high intake of saturated fatty acids or an additional increase of free sugar in the maternal diet exerts effects on weight status and body fat in the offspring and may result in dysfunction of metabolically active organs including adipose tissue, brain, liver and muscle. Potential underlying mechanisms may involve proinflammatory and epigenetic processes. Whether prenatal prevention concepts may have a beneficial long-term impact on later offspring health is currently unclear. Promotion of breastfeeding and avoidance of rapid postnatal weight gain in the first 2 years of life are essential components of the practicing pediatrician's efforts for overweight prevention