Fetal Development Expert Lectured at School (web article)

“Life is about tradeoffs. The body can’t perfect everything,” said David Barker, BSc, PhD, MD, FRCP, FRCOG, FRS, a world leader in fetal programming research, during a lecture on fetal growth, development and disease on June 14 at the Johns Hopkins Bloomberg School of Public Health.

Drs. Maureen Edwards, David Barker, Lynn Goldman and Lisa Firth

Dr. Barker is credited with developing the Fetal Origins of Adult Disease Hypothesis, which is the belief that adverse conditions in utero and during infancy increase the risk of cardiovascular disease in later life. Dr. Barker explained that while in the womb, the body can only allocate energy to developing one physical trait at a time, thus reducing allocation to one or more other traits. During critical windows of development, the body alters gene expression which leads to adaptation, and sometimes, to a predisposition for disease.

Dr. Barker is a professor at the University of Southampton School of Medicine in London, England. He and his fellow researchers found that smaller babies (those weighing less than six pounds at birth) were more likely to grow into adults with an increased risk of developing coronary heart disease, Type 2 diabetes or hypertension. He also discovered that rapid weight gain after birth had long-term costs associated with it. Weight gain when children are 3-12 months old correlates to heart disease later in life, whereas weight gain from birth to three months is an important indicator of the development of diabetes. Body size at one year of age can predict coronary heart disease later in life.

Dr. Barker said that lower birth weight babies are vulnerable, but not doomed. He also conceded that there will always be a few people who do not follow these findings. He said, “Weight at birth and subsequent weight gain matters a huge amount to some people and not at all to others.”

Barker explained that his research has public health implications for preventing coronary heart disease. To protect against it, mothers should have a varied, yet balanced, diet before conception and young children should be prevented from gaining weight rapidly, particularly children who are born small for gestational age.

The lecture was sponsored by the Maryland Mothers and Babies Study (MMBS), a children’s environmental health research project based at the School. The event was attended by faculty, students and staff, as well as representatives from state and local health departments, local foundations and child health advocacy organizations from around the state.

“The Maryland Mothers and Babies Study was delighted to have the opportunity to sponsor Dr. Barker’s visit to Johns Hopkins,” said Lynn Goldman, MD, MPH, principal MMBS investigator and a professor in the School's Department of Environmental Health Sciences. MMBS will examine environmental influences on the health of a cohort of children who will be followed from conception into adulthood.

Dr. Barker’s lecture was one in a series of lectures that the MMBS plans to sponsor in order to help define the key questions, methodologies and collaborations for the investigation.