Maternal nutrition, fetal and childhood growth, and programming of cardiovascular disease and diabetes in South Asians

南亚人患冠心病（CHD）、2型糖尿病和胰岛素抵抗综合征的风险高于白种人。这与南亚人特有的体型有关：低肌肉量，高体脂和中（腹部）肥胖。英国和欧洲最近的研究表明，出生时体型较小，婴儿期体重较轻，童年时期体重迅速增加，预示着成年后冠心病和糖尿病的发病率较高。这就产生了一种理论，即影响早期生长的环境因素可以永久性地改变身体。S结构和代谢，导致后期疾病。早期生活规划可能解释了南亚人冠心病和糖尿病的高发率，他们在出生和婴儿期通常又轻又瘦。申请人在印度建立了一个研究项目，与四个中心的同事合作，研究南亚胎儿、婴儿和儿童生长与冠心病和糖尿病的关系。迄今为止的研究已经证实，低出生体重和儿童期体重迅速增加与较高的冠心病风险因素以及成年后冠心病和糖尿病的增加有关。较低的出生体重和婴儿体重预示着较低的成年肌肉量，而在童年时期体重迅速增加预示着较大的成年体脂。对怀孕的研究表明？low-muscle脂肪吗?体型在印度新生儿中是存在的。新生儿脂肪与母体体脂和母体糖尿病有关。摄入微量营养素丰富的食物（绿叶蔬菜、水果和牛奶）较少的母亲生下的婴儿在所有身体测量中都更小。在未来的5年里，我们将研究母亲的营养和母亲的糖尿病对她的孩子的关系。s的身体成分和冠心病危险因素概况。在一项旨在直接检验编程假说的研究中，将对营养不良的母亲进行一项改善饮食质量的随机对照试验，目的是改善胎儿的生长和后来的结果。这项研究的前提是成人疾病可以通过优化胎儿、婴儿和儿童营养的措施来预防。我们的目标是确定这一前提的有效性，并制定此类干预措施。

South Asians have a higher risk of developing coronary heart disease (CHD), type 2 diabetes and the insulin resistance syndrome than white caucasians. This is related to a characteristic South Asian body type: low muscle mass, high body fat and central (abdominal) obesity. Recent research in the UK and Europe has shown that smaller size at birth, lower weight during infancy, and rapid weight gain in childhood, predict higher rates of adult CHD and diabetes. This has given rise to the theory that environmental factors influencing early growth can permanently alter (?programme?) the body?s structure and metabolism, leading to later disease. Early-life programming may explain the high rates of CHD and diabetes in South Asians, who are typically light and thin at birth and in infancy. The applicant has established a research programme in India, collaborating with colleagues in four centres, to study the relationship of fetal, infant and childhood growth, to CHD and diabetes in South Asians. Work so far has confirmed that low birthweight and rapid weight gain in childhood are associated with higher CHD risk factors and increased adult CHD and diabetes. Lower birthweight and infant weight predict lower adult muscle mass, while rapid weight gain in childhood predicts greater adult body fat. Studies in pregnancy showed that the ?low-muscle high-fat? body type is present in Indian newborn babies. Neonatal fat is related to maternal body fat and maternal diabetes. Mothers with lower intakes of micronutrient-rich foods (green leafy vegetables, fruit and milk) had babies that were smaller in all body measurements. In the next 5 years we will study the relationship of maternal nutrition and maternal diabetes to her children?s body composition and CHD risk factor profile. In a study designed to directly test the programming hypothesis, a randomised controlled trial of improved diet quality in undernourished mothers will be undertaken, with the aim of improving fetal growth and later outcomes. The premise of this research is that adult disease may be preventable by measures that optimise fetal, infant and childhood nutrition. Our objectives are to determine the validity of this premise and to develop such interventions.