New discoveries reveal how crucial interactions which determine our destiny occur before birth, when our genes interact with their environment as the embryo and fetus develop. These processes - in the matrix of the womb - are evolutionary echoes of mechanisms which allowed our hunter-gatherer ancestors to survive. These exciting insights into predictive adaptive responses suggest new ways of protecting the health of the fetus, infant and adult. If inappropriate they can trigger obesity, diabetes and heart disease, formerly thought to result solely from adult lifestyle. The new concepts in this book are crucial to understanding the daunting public health burden in societies undergoing rapid transition from poverty to affluence. They add an important new dimension to evolutionary theory. Synthesising developmental biology, evolutionary history, medical science, public health and social policy, this is a ground-breaking and fascinating account by two of the world's leading pioneers in this important emerging field.

https://bilder.buecher.de/zusatz/21/21302/21302478_vorw_1.pdf

The Fetal Matrix: Evolution, Development and Disease

Objective This study aimed to assess the effects of 9-hour time-restricted feeding (TRF), early (TRFe) or delayed (TRFd), on glucose tolerance in men at risk for type 2 diabetes. Methods Fifteen men (age 55 ± 3 years, BMI 33.9 ± 0.8 kg/m2 ) wore a continuous glucose monitor for 7 days of baseline assessment and during two 7-day TRF conditions. Participants were randomized to TRFe (8 am to 5 pm) or TRFd (12 pm to 9 pm), separated by a 2-week washout phase. Glucose, insulin, triglycerides, nonesterified fatty acids, and gastrointestinal hormone incremental areas under the curve were calculated following a standard meal on days 0 and 7 at 8 am (TRFe) or 12 pm (TRFd). Results TRF improved glucose tolerance as assessed by a reduction in glucose incremental area under the curve (P = 0.001) and fasting triglycerides (P = 0.003) on day 7 versus day 0. However, there were no mealtime by TRF interactions in any of the variables examined. There was also no effect of TRF on fasting and postprandial insulin, nonesterified fatty acids, or gastrointestinal hormones. Mean fasting glucose by continuous glucose monitor was lower in TRFe (P = 0.02) but not TRFd (P = 0.17) versus baseline, but there was no difference between TRF conditions. Conclusions While only TRFe lowered mean fasting glucose, TRF improved glycemic responses to a test meal in men at risk for type 2 diabetes regardless of the clock time that TRF was initiated.

Time-Restricted Feeding Improves Glucose Tolerance in Men at Risk for Type 2 Diabetes: A Randomized Crossover Trial.

Background Low birth weight has been associated with increased risk of type 2 diabetes mellitus, cardiovascular disease, and hypertension, but the risk at high birth weight levels remains uncertain...

Birth Weight and Risk of Type 2 Diabetes Mellitus, Cardiovascular Disease, and Hypertension in Adults: A Meta-Analysis of 7 646 267 Participants From 135 Studies.

Lipid profiles in middle-aged men and women after famine exposure during gestation: the Dutch Hunger Winter Families Study

Review Form First Author, Year: ___________________ Ref ID #__________ Abstractor Initials: ___ ___ ___ Primary Inclusion/Exclusion Criteria 1. Relevant to SER topic Yes No Cannot Determine 2. Attempts internal or external validation Yes No Cannot Determine 3. Published in English Yes No Cannot Determine 4. Original research (exclude reviews, editorials, commentaries, letters to editor, etc.) Yes No Cannot Determine 5. Eligible Study types a. Randomized controlled trials b. Controlled clinical trials

Systematic Review of Cardiovascular Disease Risk Assessment Tools

Objectives - To investigate whether impaired fetal growth, measured by low birth weight and short birth length, is linked with raised levels of serum lipids and increased risk and mortality of coronary heart disease. Design - The association between birth length, birth weight, Ponderal Index and total serum cholesterol was examined in 545 Danish men and women aged 31 to 51 years who participated in the Ebeltoft Health Promotion Project in Denmark. Results - No associations were found in women. For men, a negative association was found between birth weight and serum total cholesterol, with a fall in mean serum total cholesterol from 6.03 mmol/l at birth weight below 3300 g to 5.64 mmol/l at birth weight above 4000. A similar association was found between birth length and serum cholesterol, with a mean value of 6.23 mmol/l at birth length below 51 cm and a mean value of 5.56 mmol/l at birth length above 54 cm. No associations were found for Ponderal Index. Between 3% and 8% of the variance in serum total ch...

Inverse association between birth weight, birth length and serum total cholesterol in adulthood.

The evolving evidence base for early diabetes detection and intensive treatment over the recent decades has likely led to a change in the profile of patients initiating type 2 diabetes treatment (1–3). Knowing in which direction the clinical profile of patients with diabetes is moving is important because treatment guidelines rely on the generalizability of clinical trials to contemporary populations (3). Many of these trials were conducted when both the diagnostic criteria and treatment targets were quite different than today (1–3). Population-based data investigating long-term trends in diabetes management and treatment targets are scarce. We aimed to examine 18-year changes in HbA1c and lipid testing and control among people initiating glucose-lowering drugs (GLDs) for type 2 diabetes. We performed one of the first population-based studies, using laboratory and health care databases covering the entire population of Northern Denmark (∼1.8 million people) (4).

We identified people redeeming their first-ever GLD prescription at age ≥30 years. For all 94,175 GLD initiators 2000–2017, we examined pretreatment HbA1c and lipid levels and proportions of testing. For initiators 2000–2016, we assessed 12 months posttreatment lipid-lowering therapy and achievement of glycemic and LDL cholesterol targets. Mean HbA1c and LDL levels and reductions were plotted with 95% CIs.

Median age at first GLD treatment fell from 64 years in 2000 to 61 in 2017; 56% of the study population were men. The proportion of patients with at least one HbA1c test within 12 months after GLD initiation increased from 53% (2000) to 95% (2016) (Fig. 1 A ). Concurrently, mean pretreatment HbA1c decreased from 9.2% (77 mmol/mol) (2000) to 7.9% (63 mmol/mol) (2017), with a nadir occurring in 2011 (7.3% [56 mmol/mol]). For mean posttreatment HbA1c, a smaller decline was seen from 7.1% …

/pdf/trends-in-hba1c-and-ldl-cholesterol-in-patients-with-type-2-3p36cx280h.pdf

Trends in HbA1c and LDL Cholesterol in Patients With Type 2 Diabetes Receiving First-Time Treatment in Northern Denmark, 2000–2017: Population-Based Sequential Cross-Sectional Analysis

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