Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

What your mother didn’t eat may determine your cause of death

Peter F. Nichol, MD, PhD
Conditions
September 19, 2017
682 Shares
Share
Tweet
Share

With the attempts to repeal and replace the Affordable Care Act, it is a good time to educate our leaders on an opportunity to significantly reduce the incidence of the most expensive and common preventable, pre-existing condition: What your mother did or didn’t eat when she was pregnant with you.

Yes, it is a pre-existing condition that determines how you die.

Confused? Let me give you a little scientific context.

Recently I was at a scientific meeting when a bloke from South Hampton England, a fellow soccer aficionado with whom I had been hitting the pubs all week, delivered a stunning narrative. Our disease risk (the diseases that will kill us) is in large part determined by what our mothers did or did not eat when they were pregnant with us.

Dr. Tom Fleming is a developmental biologist who has devoted his research career to understanding the Dutch Hunger Winter during the Nazi occupation of 1944. The incidence and severity of common diseases (heart disease, high blood pressure, diabetes, obesity, kidney disease and mental illness) in people conceived during the Hunger Winter increased dramatically even though these people were essentially genetically identical to the Dutch generations that preceded them.

The effects of the Hunger Winter changed the structure, but not the code of their DNA. Molecules normally added to the DNA backbone to control or limit the expression of certain genes were removed. This unleashed a torrent of gene expression that irretrievably increased their risk for these diseases. These alterations are termed epigenetic changes.

Tom developed an animal model to study how these changes come about. His work determined that protein malnutrition early in pregnancy induces the epigenetic changes that increase the risks of Hunger Winter associated diseases. Even more alarming was these epigenetic changes persist through at least two generations, as seen in the offspring of Hunger Winter children. Thus, what you die from is in large part determined by what your grandmother or mother did, or did not eat.

In other words, the conditions that determine your disease risk are pre-existing. And there is little that can be done once this process has been set in motion.

From a teleological standpoint, the obvious question is whether there is a biological advantage to this epigenetic response. After all, biology doesn’t do anything without an overarching purpose.

Tom answered this the following way: If you are a hunter-gatherer in a protein-poor environment, then you need to birth better hunter-gatherers for your lineage to survive. In this scenario, higher blood sugar, and higher blood pressure give you a readily available energy supply and more blood flow to your muscles. This increases your chances of capturing protein rich quarry.

You also must efficiently store energy (in the form of fat) for those lean times in between successful hunts, making you predisposed to obesity. You are hyperactive as well, and thus more vigilant; an advantage when hunting, but a trait that puts you at higher risk of mental illness.

What about advanced heart disease? In a protein-poor environment, after you have procreated and raised your offspring, you shouldn’t stick around too long. It is to no one’s benefit for you to compete with your adult offspring or your offspring’s offspring for scarce resources. For the benefit of your progeny and their progeny, you succumb to heart disease.

As I listened to his presentation, I calculated the annual cost of these diseases in the United States. They account for about a third of health care expenditures in the U.S., or approximately $1 trillion. This, of course, raises the question of how much money we could save and misery we could prevent if only we could optimize nutrition in gestating women.

This last point brings me back to our political leaders who are working on health care reform.

If they want to achieve the dual goals of making the nation healthier and reducing health care expenditures, they have a tremendous opportunity at hand. By developing scientifically guided policies and nutritional strategies to reduce the incidence and severity of these diseases we can save tens of trillions of dollars over scores of years.

The question is: Do we have the will and long-term discipline to address this preventable, pre-existing condition?

Peter F. Nichol is chief medical officer, Medaware Systems.

Image credit: Shutterstock.com

Prev

How Hurricane Harvey changed this medical student

September 19, 2017 Kevin 1
…
Next

The key to financial freedom: Live and work like a resident

September 20, 2017 Kevin 1
…

Tagged as: Cardiology, Genetics, OB/GYN

Post navigation

< Previous Post
How Hurricane Harvey changed this medical student
Next Post >
The key to financial freedom: Live and work like a resident

More by Peter F. Nichol, MD, PhD

  • Rethinking consent in the age of Facebook and Cambridge Analytica

    Peter F. Nichol, MD, PhD
  • A better way of using Lyft and Uber in health care

    Peter F. Nichol, MD, PhD
  • If academic medicine is to avoid becoming academic, it must prioritize patient care

    Peter F. Nichol, MD, PhD

Related Posts

  • I challenge you to discuss death

    Emily S. Hagen
  • My grandfather’s death: What I’ve learned about life

    Munera Ahmed
  • Death and Dvořák

    Daniel Song
  • Medical error is not the third leading cause of death

    Skeptical Scalpel, MD
  • How death is a blessing and a burden

    Fatema Shipchandler
  • I never expected death to be so blunt

    Natasha Mathur

More in Conditions

  • Unlocking the secrets of cancer conferences: an end-of-life counselor’s journey among pharmaceutical giants

    Althea Halchuck, EJD
  • An obstetrician-gynecologist reveals the truth about reproductive planning and how to navigate society’s expectations

    Yuliya Malayev, DO, MPH
  • Nose-brain connection: The surprising link between allergies and mental health revealed

    Kara Wada, MD
  • Is the rise in mental illness due to greater awareness or a true increase in incidence?

    Zahid Awan, MD
  • A patient’s perspective on the diminishing relationship between doctors and patients

    Michele Luckenbaugh
  • How misused terminology and biased studies may be misguiding our understanding of opioid addiction and mortality

    Richard A. Lawhern, PhD
  • Most Popular

  • Past Week

    • A patient’s perspective on the diminishing relationship between doctors and patients

      Michele Luckenbaugh | Conditions
    • Unmasking wage disparity in health care: the truth behind the Elmhurst Hospital physician strike

      Kevin Pho, MD | KevinMD
    • Why affirmative action is crucial for health equity and social justice in medicine

      Katrina Gipson, MD, MPH | Policy
    • How electronic health records preserve patients’ legacies in the words of oncologists

      Marc Braunstein, MD, PhD | Physician
    • Unmasking the brutal reality of gun violence in America: a call to action for unity and meaningful change

      Osmund Agbo, MD | Policy
    • Emulating Michael Jordan’s winning mindset: a path to success for health care professionals and entrepreneurs

      Harvey Castro, MD, MBA | Physician
  • Past 6 Months

    • The growing threat to transgender health care: implications for patients, providers, and trainees

      Carson Hartlage | Policy
    • Breaking point: the 5 reasons American doctors are dreaming of walking away from medicine

      Amol Shrikhande, MD | Physician
    • “Is your surgeon really skilled? The hidden threat to public safety in medicine.

      Gene Uzawa Dorio, MD | Physician
    • It’s time to replace the 0 to 10 pain intensity scale with a better measure

      Mark Sullivan, MD and Jane Ballantyne, MD | Conditions
    • Breaking the cycle of racism in health care: a call for anti-racist action

      Tomi Mitchell, MD | Policy
    • Revolutionize your practice: the value-based care model that reduces physician burnout

      Chandravadan Patel, MD | Physician
  • Recent Posts

    • Why doctors aren’t to blame for the U.S. opioid crisis [PODCAST]

      The Podcast by KevinMD | Podcast
    • Raw humanity on night float: inspiring patient encounters and overcoming challenges

      Johnathan Yao, MD, MPH | Physician
    • Is AI the solution for the shortage of nephrologists? ChatGPT weighs in.

      Amol Shrikhande, MD | Tech
    • Unlocking the secrets of cancer conferences: an end-of-life counselor’s journey among pharmaceutical giants

      Althea Halchuck, EJD | Conditions
    • Why HIPAA is failing and what you need to know to protect your data [PODCAST]

      The Podcast by KevinMD | Podcast
    • Revolutionizing emergency medicine: Overcoming long-term challenges with innovative solutions for physicians and patients

      Anonymous | Physician

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

Leave a Comment

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

CME Spotlights

From MedPage Today

Latest News

  • What Drug Did FDA Just Approve for COVID?
  • PET Scan for Alzheimer's Dx; Predicting Colon Cancer Survival
  • What Happens When We Classify Kids' Weight as a 'Disease'?
  • Sotagliflozin Gets FDA's Blessing for Heart Failure
  • Cardiorespiratory Monitoring Can Be Telling of Outcomes in Extremely Preterm Infants

Meeting Coverage

  • No Access to Routine Healthcare Biggest Barrier to HPV Vaccination
  • Trial Results Spark Talk of Curing More Metastatic Cervical Cancers
  • Cross-Border Collaboration Improves Survival in Pediatric Leukemia Patients
  • Monoclonal Antibody Reduced Need For Transfusions in Low-Risk MDS
  • Less-Invasive Surgery for Pancreatic Cancer Proves Safe, Effective
  • Most Popular

  • Past Week

    • A patient’s perspective on the diminishing relationship between doctors and patients

      Michele Luckenbaugh | Conditions
    • Unmasking wage disparity in health care: the truth behind the Elmhurst Hospital physician strike

      Kevin Pho, MD | KevinMD
    • Why affirmative action is crucial for health equity and social justice in medicine

      Katrina Gipson, MD, MPH | Policy
    • How electronic health records preserve patients’ legacies in the words of oncologists

      Marc Braunstein, MD, PhD | Physician
    • Unmasking the brutal reality of gun violence in America: a call to action for unity and meaningful change

      Osmund Agbo, MD | Policy
    • Emulating Michael Jordan’s winning mindset: a path to success for health care professionals and entrepreneurs

      Harvey Castro, MD, MBA | Physician
  • Past 6 Months

    • The growing threat to transgender health care: implications for patients, providers, and trainees

      Carson Hartlage | Policy
    • Breaking point: the 5 reasons American doctors are dreaming of walking away from medicine

      Amol Shrikhande, MD | Physician
    • “Is your surgeon really skilled? The hidden threat to public safety in medicine.

      Gene Uzawa Dorio, MD | Physician
    • It’s time to replace the 0 to 10 pain intensity scale with a better measure

      Mark Sullivan, MD and Jane Ballantyne, MD | Conditions
    • Breaking the cycle of racism in health care: a call for anti-racist action

      Tomi Mitchell, MD | Policy
    • Revolutionize your practice: the value-based care model that reduces physician burnout

      Chandravadan Patel, MD | Physician
  • Recent Posts

    • Why doctors aren’t to blame for the U.S. opioid crisis [PODCAST]

      The Podcast by KevinMD | Podcast
    • Raw humanity on night float: inspiring patient encounters and overcoming challenges

      Johnathan Yao, MD, MPH | Physician
    • Is AI the solution for the shortage of nephrologists? ChatGPT weighs in.

      Amol Shrikhande, MD | Tech
    • Unlocking the secrets of cancer conferences: an end-of-life counselor’s journey among pharmaceutical giants

      Althea Halchuck, EJD | Conditions
    • Why HIPAA is failing and what you need to know to protect your data [PODCAST]

      The Podcast by KevinMD | Podcast
    • Revolutionizing emergency medicine: Overcoming long-term challenges with innovative solutions for physicians and patients

      Anonymous | Physician

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Leave a Comment

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...