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You are what your Ouma ate

- Beth Amato

The health of your mother when you were born is a known indicator of your prospects in future, but new research shows that you inherit your health even earlier.

In the UK in 1911, Ethel Burnside, the Lady Inspector of Midwives in Hertfordshire was tasked with improving children’s health. There was widespread concern at the time that the health of the general population was very poor. In meticulously recorded ledgers, midwives documented each baby’s birth weight and, on subsequent visits, their illnesses, methods of infant feeding, and weights as one-year-olds. 

This data, which ultimately led to the hypothesis of the developmental origins of health and disease, proved seminal in understanding the link between a mother’s pre- and postnatal health and her child’s health, and then, especially, the child’s health in its adult years. 

The Hertfordshire research study revealed that a low birth weight was associated with an increased risk of developing coronary heart disease and type two diabetes, metabolic syndrome, insulin resistance, osteoporosis and sarcopenia [degenerative loss of skeletal muscle mass] in later life. 

Further studies conducted around the world have suggested that the nourishment a baby receives from its mother during pregnancy, as well as its nutrition and illnesses in infancy and early childhood, determine susceptibility to disease in later life.

Chicken and rice at Roving Bantu Kitchen. ©Lauren-Mulligan | 

In South Africa, data from the Birth to Twenty Plus (Bt20+) cohort study at Wits, which is Africa’s longest-running longitudinal cohort study, confirms that the first 1 000 days of a child’s life are critical for later health. 

What makes the Bt20+ findings so significant is the discovery that not only is a mother’s nutrition critical during pregnancy, but a grandmother’s antenatal nutrition is too. Research shows that a mother’s nutritional status (which uses height as an indicator) and her infant daughter’s birth size are significantly linked with the birth size of that daughter’s own baby (when she has given birth herself later on). 

This suggests that the nutritional status of the grandmother affects the grandchild’s risk profile for cardiovascular, metabolic, immune and neurological morbidities via her programming influence on the mother during the foetal period. 

Professor Shane Norris, Co-Principal Investigator of the Bt20+ study at the Medical Research Council/Wits Developmental Pathways for Health Research Unit, has confirmed that the impact of under-nutrition persists across generations. Therefore, interventions aimed at improving nutrition for pregnant women and for children in the first 1 000 days of life are key. 

But your grandma might get off the hook. Other factors also contribute to your health trajectory throughout your life. 

“While pregnancy and infancy are crucial periods, new research suggests that the next 7 000 days until a child hits official adulthood are also important and sensitive times in terms of health outcomes,” says Norris. 

A child with a high risk of developing diabetes as an adult – because of inherited nutritional deficiency – may not necessarily get diabetes if there were appropriate nutritional and environmental interventions during childhood and adolescence, particularly not gaining rapid or excess weight as a child. 

Yes, we are profoundly affected by the diets of our ancestors, but there are potentially opportunities to change health trajectories. 

  • Beth Amato is a freelance journalist.
  • This article first appeared in Curiosity, a research magazine produced by Wits Communicationsand the Research Office.
  • Read more in the sixth issue, themed: #HungerGames where our researchers and academics unpack the latest research on food security, food science, food politics and governance, nutrition and food-related issues such as obesity, diets, breastfeeding, and body image.