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Early life influences on cardio-metabolic disease risk in aboriginal populations-what is the evidence? A systematic review

We systematically reviewed the published evidence for the developmental origins of health and disease hypothesis among aboriginal populations from Australia,...

Authors:
McNamara BJ; Gubhaju L; Chamberlain C; Stanley F; Eades SJ

Authors notes:
International Journal of Epidemiology. 2012;41(6):1661-1682

Keywords:
Cardio-metabolic disease, Cardiovascular disease, Developmental origins of health and disease, Foetal growth, Indigenous people, Renal disease, Type 2 diabetes

Abstract:
We systematically reviewed the published evidence for the developmental origins of health and disease hypothesis among aboriginal populations from Australia, Canada, New Zealand and the USA.

There was strong evidence for an association between birth weight and type 2 diabetes (6/7 studies), impaired kidney function (6/7 studies) and high blood pressure (5/6 studies), whereas there was limited evidence for an association with metabolic abnormalities (4/7 studies) and adiposity (4/7).

Exposure to maternal diabetes was strongly associated with type 2 diabetes (9/10 studies) and metabolic abnormalities (5/7 studies), whereas the association with adiposity was low (3/9 studies); the limited number of studies, to date, also show a relationship with high blood pressure (2/2 studies).

This review highlights that interventions to reduce the burden of cardio-metabolic disease among aboriginal populations should focus on improving maternal health, particularly by reducing the prevalence of diabetes in pregnancy.

Future research should also be directed towards potential protective actions, such as breastfeeding.