The Tip

The Tipping Point in Obesity

The tipping point in obesity increasingly looks like it might be traced to the metabolic health of mothers.

Growing evidence for epigenetic effects of maternal health that transmit obesity from mother to child is part of this picture. A symposium at ObesityWeek 2014 provided an excellent overview of the emerging science on epigenetic mechanisms for transmitting obesity from generation to generation. Epigenetics involve changing the way our genes work without changing the genes themselves. And some of these changes can be inherited by subsequent generations.

Evidence is building that maternal exercise regulates the obesity and metabolic health in a mother’s children. A role for fetal programming in a child’s health and behavior is becoming increasingly clear. It’s also becoming clear that maternal nutrition has an effect on epigenetics and obesity in a mother’s offspring.

Edward Archer pulls together all of this emerging science and more in a special article just published in the Mayo Clinic Proceedings. He proposes a “Maternal Resources Hypothesis” that explains the excess of childhood obesity as the inevitable result of a non-genetic evolution of mothers and their offspring. Changes in our communities, food, and physical activities have favored adipocytes — fat cells — claiming a dominant share of the energy available to mothers and their offspring. As a result, he says:

A metabolic tipping point was reached at which the postprandial insulin response was so intense, the relative number of adipocytes so large, and inactivity so pervasive that the competitive dominance of adipocytes in the sequestering of nutrient energy was inevitable and obesity was unavoidable.

His theory has important implications for how we work to reduce the impact of obesity. It suggests that maternal health has central importance — especially before and during pregnancy. It suggests that simply focusing on children at risk from obesity will not be enough to reverse the problem we have.

As if to reinforce the point, new data surfaced this week from the Framingham Heart Study showing that a mother’s weight before pregnancy might have a big effect on the caridiometabolic health of her children many decades later. Presenting at the American Heart Association (AHA) Scientific Sessions, lead researcher Michael Mendelson said:

What we’re showing here, there may be a potential benefit in the next generation, decades later. To think that you can see that connection over so long, it’s unbelievable. And the genetic sequences aren’t explaining as much as we initially thought.

A central role for maternal health and epigenetics provides a fresh way of looking at the problem of obesity. Testing the practical application of this view will be essential.

“Only mothers can think of the future — because they give birth to it in their children.” — Maxim Gorky

Click here for more on Archer’s paper and here to read the paper itself. Click here for more from the AHA on the study presented at their meeting and here for more from the Washington Post. Click here for the abstract of the study.

The Tip, photograph © whologwhy / flickr

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