• Programme 4’s cohort studies in LMICs have shown that several pre-natal and childhood exposures are associated with an increased risk of later type 2 diabetes, hypertension and cardiovascular disease. These include: (pre-natal) maternal gestational diabetes, maternal micronutrient deficiencies (vitamins B12 and D), intra-uterine growth restriction and (post-natal) weight faltering in infancy and rapid weight gain in late childhood/adolescence.
  • These cohort studies have also shown several pre-natal and post-natal exposures associated with poorer cognitive function in later life. These include: lower parental socio-economic status and education level, maternal micronutrient deficiencies (vitamins B12 and folate), lower birth weight, weight and height faltering in infancy and childhood.
  • Exposure as a fetus to gestational diabetes in the mother is associated with cardiometabolic alterations in children, including increased adiposity, insulin resistance, and cardiovascular stress responsiveness.
  • Adults with impaired glucose tolerance or impaired fasting glucose (indicators of a high risk of developing later type 2 diabetes) had higher glucose concentrations and lower insulin responses to a glucose load even as young children, and had lower birth weights.
  • A food-based nutritional intervention (micronutrient-rich foods) starting before pregnancy and continuing until delivery increased birth weight and reduced the incidence of gestational diabetes. The effect on birth weight varied according to maternal BMI (less benefit among thinner mothers). Ongoing research is studying longer-term effects of maternal supplementation on the children’s health (body composition, cardiometabolic risk markers, cognitive function).