A wide study of more than 2000 children of women with gestational diabetes, a diabetes that some women get during pregnancy, has revealed that obesity in mothers is one of the most decisive factors contributing to the appearance of congenital malformations in their children, even more so than the seriousness of the diabetes.
The research, published in the European journal Diabetologia (47 (3):509-514) was carried out by a research team from the Universitat Autònoma de Barcelona and Hospital de Sant Pau in Barcelona, Spain.
Science has known since the 1960s that children of women with diabetes before pregnancy have a higher possibility of having congenital malformations, which are primarily related with the mother's degree of hyperglycemia (high blood sugar) during the period in which the embryo's organs are forming.
In the children of women with gestational diabetes, first detected during pregnancy, the risk of malformations does not increase so much, but it does still exist. In this case, during the period when the embryo's organs are forming the glucose levels are usually fairly unaltered.
But new findings from the Spanish researchers suggest that the body mass index, which indicates obesity, is more important in predicting malformations than other variables that indicate the seriousness of the maternal diabetes mellitus.
The research team at the Universitat Autònoma de Barcelona and the Hospital de Sant Pau headed by Doctor Rosa Corcoy reached this conclusion after analysing the relationship between the mother's glucose levels and congenital malformations in the children of mothers with gestational diabetes. They decided to include the body mass index as a variable for the statistical analysis because that it has been demonstrated that obesity plays a part in congenital malformations in embryos, especially those related to the heart and the central nervous system.
Obesity has reached epidemic proportions globally, with more than 1 billion adults overweight - at least 300 million of them clinically obese - and is a major contributor to the global burden of chronic disease and disability. Obesity and overweight pose a major risk for chronic diseases, including type 2 diabetes, cardiovascular disease, hypertension and stroke, and certain forms of cancer.
Increased consumption of more energy-dense, nutrient-poor foods with high levels of sugar and saturated fats, combined with reduced physical activity, have led to obesity rates that have risen three-fold or more since 1980 in some areas of North America, the UK, Eastern Europe, the Middle East, the Pacific Islands, Australasia and China, writes the UN-backed World Health Organisation (WHO).
According to the study's results, the mother's degree of obesity is the main predicting factor for cardiac malformations and minor malformations, and the only factor able to predict renal and urinary tract malformations. The seriousness of the mother's gestational diabetes was the only factor that could predict skeletal malformations.
The researchers claim that previous studies have not identified the degree of obesity as contributing to the risk of cardiac malformations in the children of woman with gestational diabetes, possibly because this variable was not actally included in the statistical analysis.
The authors of the study suggest two possible explanations for obesity's important role in congenital malformations. Obesity is an indicator of energy availability and of all the nutrients that provide energy; the excess of these nutrients, and not only glucose, is linked with the appearance of malformations.
In addition, both the excess and deficiency of insulin can provoke malformations in the embryo, and in the case of obesity, the fact that there is a resistance to the effects of the insulin results in higher concentrations, concluded the Spanish scientists.
Under the spotlight in the food industry today, the topic of obesity was the focus of a key discussion that took place last week at the Institute of Food Technologists' annual meeting in Las Vegas that finished on Friday.
Speaking at the meeting Linda Gilbert, president of HealthFocus International, a market research firm that specialises in health trends suggested that for food companies to make an impact in the obesity epidemic, they should moving away from 'deprivation' and toward 'satisfaction'. Instead of telling people what they can not eat, the industry needs to tell people what they can eat to manage hunger.
"Dieting is an outdated word in shopper's vocabulary," said Gilbert. Instead consumers use more positive phrases like "I'm being good," "I'm being healthy," and "I'm watching what I eat." .
"Convenience and taste still rule," added John Stanton, professor of Food Marketing at St. Joseph's University. "If you want diet food you want convenient and tasty diet food."
Both Stanton and Gilbert agree that what will motivate consumers and food companies are the consequences of being overweight. For adults these consequences will include health problems associated with obesity such as diabetes and heart disease, and the quality of life.