Gluckman - prenatal epigenetics

Perhaps the biggest advance in our understanding of fetal development has been that we can measure changes in the switches regulating genes and fetal tissues, or in the tissues like the placenta and the umbilical cord at birth. And we call these changes epigenetic changes. They are not actually changes in the DNA sequence itself. But every gene has lots of switches on them, and these switches can be set in different positions, like a whole bank of sliders on a sound equalizer. And they can be set in early life, and many of them, are once they’re set in early life, stay in that position, as best we can tell, for the whole of life.

Now what we have learnt from this new molecular biology that allows us to measure some of these switches, and there can be thousands of these switches on every gene, there are literally millions and millions of them in the genome and many of them do other things, so there’s many more roles epigenetics than what I’m talking about here, but the ones that we’re talking about here, is they can be influenced by a number of things. We focused a lot on nutrition because that’s where the experimental science started, and nutrition certainly has effects. But we know other things also have switches effects. We know that maternal mood has an effect, we know that stress has an effect, we know that maternal weight gain has an effect. We have we know a lot more about this than we used to know.

Some of those things are amenable to better care of the mother and father, others of them we can’t do anything about. For example, the switches are set a bit differently in first born children, rather than second born children. And we know that first born children have a greater risk of getting obese and getting insulin resistant, that is risk of getting diabetes than are second born children. But, we can’t do anything about that, but it’s interesting to reflect on the fact that there are far more first born children in the world now, as family size has fallen than there was in the past. But, others we can potentially do something about. Maternal mood, maternal stress, workload for women in many countries is unacceptably high, and leads to changes in the fetus we think. Nutrition, and we are learning; have to learn so much more about the role of both macronutrients, micronutrients, screening for gestational diabetes, thinking about gestational weight gain. We’ve already talked about the fact that some of this happens very early in pregnancy, before women know that they are pregnant, which means we have to think about the mother and the father before conception. We’re learning a lot more, but it’s fair to say we don’t know everything.