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  • Print publication year: 2006
  • Online publication date: August 2009

18 - The developmental environment and the development of obesity

Summary

The pandemic of obesity: what are its origins?

The incidence of childhood and adult obesity continues to increase annually worldwide within both developed and developing countries, despite substantial international research into the potential mechanisms that may underlie this pandemic. Indeed worldwide there are now as many individuals who are overnourished as are undernourished. The speed with which obesity, has risen, particularly in countries such as India and China as they adopt Western diets and lifestyles, strongly suggests that genetic factors are not the explanation. Currently nearly all research and intervention strategies are targeted towards adult obesity, which could explain the failure to reduce its incidence. Given the growing body of epidemiological and experimental evidence demonstrating that obesity is programmed in utero, this anomaly should be addressed. The potential significance of fetal programming to later health is emphasised by the fact that obesity alone is not only a major health risk itself, but is also an adverse factor contributing towards hypertension (Hall 2003) and cancer (Bray 2002).

Epidemiological evidence for fetal programming of obesity

Taken together, the overall consensus from epidemiological studies is that being either small or large at birth predicts later obesity (Law et al. 1992, Sorensen et al. 1997). Whether this is the result of changes within the adipocyte itself, or in appetite control, or a combination of both, remains an area of intense debate within the field of obesity research.

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