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Is The Fate of Our Health Decided In the Womb?

There is an entire field of research, known as fetal origins, whose raison d’etre is to prove that we are who we are today because of what happened to us in the womb. What makes us the way we are? Why are some people predisposed to be anxious, overweight or asthmatic? How is it that some of us are prone to heart attacks, diabetes or high blood pressure? According to fetal origin researchers, it all has to do with your Mother.

Of course, there's a list of conventional answers to many of these questions. We are the way we are because it's in our genes: the DNA we inherited at conception. We turn out the way we do because of our childhood experiences: how we were treated and what we took in, especially during those crucial first three years. Or our health and well-being stem from the lifestyle choices we make as adults: what kind of diet we consume, how much exercise we get.

However, the kind and quantity of nutrition you received in the womb; the pollutants, drugs and infections you were exposed to during gestation; your mother's health, stress level and state of mind while she was pregnant with you — all these factors shaped you as a baby and a child and may continue to affect you to this day.

While there is no disputing that what a woman does during pregnancy affects the fetus and then the baby it becomes, many scientists reject the proposition that the diabetes or heart disease you are diagnosed with at age 40 was directly related to your experience in utero.

According to the original theory, a person’s time in the womb is the single most important and influential period of their whole life. The brain and organs of the body are permanently imprinted during this time and fashion our susceptibility to certain diseases, how fast our metabolisms are, our intelligence levels, and the disposition that comes naturally to us.

Fetal origin pioneers assert that the nine months of gestation constitute the most consequential period of our lives, permanently influencing the wiring of the brain and the functioning of organs such as the heart, liver and pancreas. The conditions we encounter in utero, they claim, shape our susceptibility to disease, our appetite and metabolism, our intelligence and temperament. In the literature on the subject, which has exploded over the past 10 years, you can find references to the fetal origins of cancer, cardiovascular disease, allergies, asthma, hypertension, diabetes, obesity, mental illness — even of conditions associated with old age like arthritis, osteoporosis and cognitive decline.

The field of fetal origins began about 20 years ago in the United Kingdom. A British physician named David Barker discovered that there was a pattern of especially high rates of heart disease throughout the poorest areas of the U.K. He set out to determine why, when cardiovascular problems are thought to mainly afflict the affluent, this held true for the very poor. What he found was a correlation between heart disease in middle age and low birth weight, which often indicates poor prenatal nutrition. In the two decades since Barker’s findings, the same results have been found among numerous studies, including the Nurses’ Health Study in Boston.

Barker’s hypothesis was that when faced with poor nutrition during gestation, the fetus focuses the minimal nutrients it does receive to assist in brain development, leaving other organs lacking. That, in turn, is what is responsible for a weak heart later in life.

This area of research has since been extended to other health connections. Studies at Harvard University have shown that a woman with excessive weight gain during pregnancy is more likely to have a child who is overweight or obese than one who gained a moderate amount of weight. Other studies done at SUNY Downstate in Brooklyn, NY, found that children born after their mothers had anti-obesity surgery were much less likely to be obese than their siblings who were born prior to the surgery. The researchers suggest that the latter group of children formed normal metabolisms during gestation.

Virtually all scientists now recognize that what a woman does during a pregnancy affects her baby. We are well aware of the devastating and long-term damage done by pregnant women who drink alcohol or use drugs. But most medical minds today now believe that the original fetal origins scientists might have put a little too much emphasis on those first nine months, and that, in truth, what is required is an integration of several theories of disease in addition to fetal origins. The genetic codes in our DNA from conception, as well as the choices we make and things we’re exposed to after birth, certainly play a large role in our health too.

The low birth weight babies of Barker’s study were most likely provided with poor nutrition during gestation. But very possibly, their nutrition did not improve throughout childhood or adulthood, as they were still living in the poorest of areas. There is a tremendous amount of evidence to prove that what we eat now greatly influences our heart health.

As for the children of mothers who had undergone weight-loss surgery, it could be that the dietary changes their mothers made subsequent to surgery caused them to be thinner than their older siblings born prior to surgery. Perhaps the bad nutritional habits were already ingrained in the pre-surgery children, but the younger ones followed the same "new" portion control and healthier eating habits that were necessary for mom to adhere to after her surgery.

And then there’s Dr. Francis Pottenger. While his research focused on cats, we can’t ignore what he proved about nutrition. His experiment used 900 cats divided randomly into five groups. Two of these groups were fed unprocessed milk and meat…essentially, a completely raw food diet. The other three groups were fed varying combinations of such cooked and processed foods as pasteurized, evaporated, and condensed milk and cooked meat.

He studied them across four generations, and in the first two groups, all four generations lived typical lifespans and led healthy lives. The three groups fed processed foods did not fare so well. In the first generation, those cats developed illnesses and diseases late in their lives. The second generation developed the illnesses and diseases earlier — toward the middle of their lifespans. The third generation came down with the illnesses and diseases near the beginnings of their lives and many did not live for even six months. There was no fourth generation, as they either died before birth or their third generation parents were sterile.

As our diets have relied more and more on heavily processed and cooked foods of low nutritive value, we should remember the lessons of fetal origins and Pottenger’s cats. Clearly, what we are putting into our bodies not only harms us now, but also harms our children…unto the third and fourth generation, biblically speaking.

Another line of research is developing interventions aimed at preventing disease. David Williams, a principal investigator at the Linus Pauling Institute at Oregon State University, is testing the notion that certain substances consumed during pregnancy can provide offspring with lifelong chemoprotection from illness. In Williams' studies, the offspring of mice that ingested a phytochemical derived from cruciferous vegetables like broccoli and cabbage during pregnancy were much less likely to get cancer, even when exposed to a known carcinogen. After they were weaned, the offspring in Williams' experiments never encountered these protective chemicals again, yet their exposure shielded them from cancer well into maturity. He predicts that one day, pregnant women will be prescribed a dietary supplement that will protect their future children from cancer. "It's not science fiction," he says. "I think that's where we're headed."

Knowledge gleaned from fetal-origins research may even benefit those of us whose births are in the past. "I always ask my adult patients what their birth weight was," says Mary-Elizabeth Patti, an assistant professor at Harvard Medical School and a physician-scientist at the university-affiliated Joslin Diabetes Center. "Patients are often surprised at the question — they expect me to ask about their current lifestyle. But we know that low-birth-weight babies become adults with a higher risk of diabetes, so having that information gives me a more complete picture of their case." Patti is researching how data about patients' birth weight could translate into tailored courses of treatment.

These possibilities may seem strange and surprising, but then the notion that we owe anything about our mature selves to our experiences during childhood was once considered preposterous too — before Sigmund Freud first pointed our attention to those formative years. With time and evidence, the idea that our health and well-being are shaped during gestation could also come to seem commonsensical. Perhaps our children, whose first snapshots were taken not in a hospital bassinet but inside a uterus, won't find the idea of fetal origins odd at all.


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