Biomedicine: 2022; 42(2): 199-202 March - April 2022 DOI: https://doi.org/10.51248/.v42i2.1260 Biomedicine- Vol. 42 No. 2: 2022 Review article Does the intrauterine condition dictate chronic metabolic disorders in the adult life? Megha Bhat Agni 1 , Pramukh Subrahmanya Hegde 1 , Praveen Rai 2 , Damodara Gowda K.M. 1 1 Department of Physiology, K.S. Hegde Medical Academy, 2 Nitte University Centre for Science Education and Research, Nitte (Deemed to be University), Mangalore, 575018, Karnataka, India (Received: November 2021 Revised: March 2022 Accepted: April 2022) Corresponding author: Damodara Gowda K. M. Email: dr_damodar@nitte.edu.in ABSTRACT Foetal development has dictated by maternal gestational diet and intrinsic factors, physical activity, and environmental stimulations. Many studies provided evidence for metabolic disorders in adult life who underwent under nutrition during their foetal life. This review is an effort to use the published data to know the effect of the intrauterine environment on chronic metabolic disorders. Here, we discuss the impact of foetal under nutrition on the development of chronic metabolic diseases. Intrauterine under nutrition negatively influences health after birth. In adults, under-nutrition in utero results in metabolic impairments and cognitive impairments. Under nutrition during foetal/embryonic development influences human physiology and has a lifelong effect, often called foetal programming. This review concludes that the intrauterine environment and foetal nutrition play a significant role in developing chronic metabolic disorders. Therefore, this study provides the necessary insight into target timely interventions in the earliest possible time to prevent offspring from developing chronic diseases in adult life. Keywords: Intrauterine environment; foetal under nutrition; chronic metabolic disorders; foetal programming. INTRODUCTION ntrauterine under nutrition negatively influences health after birth. An undernourished foetus is more likely to develop hypertension, insulin resistance, diabetes mellitus, obesity, and cognitive function impairment in adulthood. This paper describes the influence of undernourishment during the perinatal period on postnatal health. Programming of the foetus occurs during the critical period of development, which involves rapid cell division and the formation of tissues and organs. Under nutrition during foetal/embryonic development influences programming human body and has a lifelong effect, often called foetal programming. An insult or stimulus during a critical period of development can have long-lasting effects on life after birth, a process known as foetal programming (1). When the foetus is exposed to an altered intrauterine environment, it alters its structural and physiological function. Once changes occur, the phenotype will be permanent and may decide the future health problems (2). It was a British Epidemiologist, David Barker, who developed the first theory of foetal programming, which showed the correlation between low birth weight and coronary heart disease, high blood pressure, and type-2 diabetes mellitus (1). Adverse nutrition in early life has been linked to adult metabolic disease according to Barker's hypothesis (3), proposed that early childhood undernourishment is associated with metabolic syndrome. It includes obesity, type-2 diabetes, hypertension, hyperlipidaemia, coronary heart disease, and stroke (4). METHODOLOGY We conducted database searches using Google Scholar, PubMed, and Science direct until September 2021 to include up-to-date documented information in the present review. We limited the search to English language papers. The data mining was done by following MeSH words such as Foetal under nutrition, chronic metabolic disorders, the effect of under nutrition, cognitive impairment. In almost all cases, we obtained the original articles and extracted the relevant data. Foetal and maternal under nutrition Foetal development had dictated by maternal gestational diet and intrinsic factors, physical activity, and environmental stimulations. Among the crucial factors that influence the programming of the body are maternal nutrition, maternal body composition, dietary pattern, and blood flow to the uterus and placenta. The altered metabolic response of the foetus to malnutrition reduces the substrate use and decreasing the metabolic rate to increase the foetal viability results in insulin resistance in adulthood. It may also be due to decreased foetal insulin, IGF, and glucose levels that ultimately reduce foetal growth (5). Insufficiency of macronutrients, proteins, and carbohydrates during pregnancy causes fetoplacental modifications. As a result, low birth weight, high blood pressure, type-2 diabetes, cardiovascular disease, and adiposity develop during adulthood. I 199