Preface. 1. Introduction. Fetal/Perinatal imprinting on later life. 2. Perinatal origins of adult disease. Obesity. 3. Perinatal origins of adult disease. Insulin resistance and Diabetes mellitus. 4. Perinatal origins of adult disease. Hypertension. 5. Perinatal origins of adult disease. Coronary heart disease. 6. Metabolic Syndrome X and low-grade systemic inflammation. 7. Long-chain polyunsaturated fatty acids in adult diseases: A hypothesis. 8. Breast-feeding. Composition and benefits. 9. Long-chain polyunsaturated fatty acids. Metabolism, physiology and clinical significance. 10. A perinatal strategy to prevent adult diseases: The Role of long-chain polyunsaturated fatty acids. Clinical implications and testing the hypothesis. Index.
Obesity, type 2 diabetes mellitus,hypertension, and coronary heart disease are serious diseases affecting asignificantnumberofadults across the globe. Insulin resistance, low-grade systemic inflammation, low-birth weight,maternalproteinmalnutrition,neonatalhighcarbohydratediet,and high fat diet are associated with these diseases. On the other hand, adequatelybreast-fedsubjects are substantially at lowerrisk. Ifso,whatis the linkbetweenthese variousfactors?Onepossibilityisthat humanbreast milk containsfactorsthatconferresistancetothese modemdiseases.Here I present arguments that long-chain polyunsaturated fatty acids (LCPUFAs) presentinthebreastmilkcouldberesponsibleforthisbeneficialaction. Though the entire class of LCPUFAs provided dunng perinatal periodislikelytohavearole inthepreventionofadultdiseases,itshouldbe understoodthateachofthese LCPUFAsexhibitauniqueand insome cases opposing bioactive properties.It is important to note that there is a close interaction between (0-6 and (0-3 fatty acids. Human breast rmlk contains almost twice (0.78 vs 0.43 %w/w)the amountof(0-6LCPUFAs (gamma linolenic acid, dihomo-gamma-linolenic acid and arachidonic acid) comparedto (0-3LCPUFAs(eicosapentaenoicacid,docosapentaenoicacid, and docosahexaenoic acid). Obviously, the best would be to mimic the composition/concentrations in which these fatty acids are present in the breastmilk. The conceptthat LCPUFAs given duringpennatalperiod(and inadultlife)isbeneficialinpreventingadultdiseasescertainlyneedsfurther exploration.Iamconfidentthat someofthe enterprisingreaderswill delve intothepossibilitiessuggestedafterreadingthisbook. UndurtiN.Das,M.D.,FAMS. To MyWifeLakshmi and Mytwoeyes DaughterArundhatiandSonAditya Chapter #1 Introduction Fetal/Perinatalimprintingonlaterlife It isbelievedthat stimuliormsults during criticalorsensitiveperiods inearlylifecanhave lifetimeconsequences.Thisconceptiswellestablished in developmental biology and has been termed "programming". The
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