Developmental ORIgins of Healthy and Unhealthy AgeiNg: the Role of Maternal Obesity
Developmental ORIgins of Healthy and Unhealthy AgeiNg: the Role of Maternal Obesity
The prevalence of obesity in the developed world has increased markedly over the last 20
 years. Considering the prevalence of obese and overweight adult subjects, and the fact that
 pregnancy itself induces a state of insulin resistance and inflammation, maternal obesity may
 be the most common health risk for the developing fetus. It is well established that what we
 eat has a major impact on our health. However, there is growing evidence to suggest that diet
 during pregnancy and lactation may be particularly important as not only does it influence
 the health of the mother, it may have a permanent effect on the health of her children and
 even her grandchildren. The concept that environmental factors, such as nutrition during
 early development, influence both our health span and lifespan has been termed the
 developmental origins of health and disease hypothesis.

 The objective of the study are:

 -  to compare subjects with frailty (condition developed with ageing) with controls and
 characterize the unhealthy aged condition with the measurements described below

 -  to examine if signs of frailty can be reversed by lifestyle induced modifications
 (exercise training programme) of its primary components (IR, sarcopenia, psychological
 profile) in offspring of overweight/obese (OOM) vs lean mothers (OLM).

 The study consists of 37 frail old subjects, age ≥ 65 sub-grouped in 17 OOM, and 20 OLM and
 11 non frail controls. These subjects will be studied with positron emission tomography
 (PET), computed tomography (CT), magnetic resonance imaging (MRI) and spectroscopy (MRS) and
 ultra sounds (US). In addition functional MRI (fMRI) will be performed. Adipose tissue
 biopsies will be taken.

 Subjects will undergo characterization of biohumoral markers, a 75 g oral glucose tolerance
 test, imaging biomarkers (PET/CT, US, fMRI-MRS), genetic biomarkers (DNA and telomere damage)
 and inflammatory biomarkers (macrophage infiltration) before and after the 4-month lifestyle
 intervention period (physical exercise). By PET/CT it will be measured tissue-specific IR in
 skeletal muscle, adipose tissue, liver, myocardium and targeted brain regions. MRS will be
 used to measure organ steatosis in the skeletal muscle and liver, MRI will be used to measure
 fat masses in abdominal areas, and fMRI will be performed to assess activation in brain
 regions regulating cognition and appetite/energy control. US will be used to assess
 cardiovascular markers (IMT, strain and function).
Inclusion Criteria:

 -  Subjects must be already participating the Helsinki Birth Cohort Study

 Frailty Groups Inclusion Criteria:

 -  (Frailty) with lowest half of adult grip strength (measured 2001-2004)

 -  Group OM: (Offspring of Obese mothers) Highest quartile of maternal BMI

 -  Group LM: (Offspring of Normal weight/Lean mothers) Lowest two quartiles of maternal
 BMI

 Control group Inclusion Criteria:

 -  (no Frailty) with highest half of adult grip strength (measured 2001-2004)

 -  Offspring of normal weight mothers

 Exclusion Criteria:

 -  Subjects whose mothers were pre-eclamptic during pregnancy

 -  Oral corticosteroid or Warfarin therapy

 -  Recent myocardial infarction

 -  Severe chronic disorder that can prevent to participate the intervention

 -  Chronic atrial fibrillation and pacemaker

 -  Cancer less than 5 years ago

 -  Current smoking

 -  Diabetes requiring insulin treatment or fasting glucose more than 7 mmol/l

 -  Weight more than 170 kg and Waist circumference > 150 cm

 -  Inner ear implants

 -  Metal objects in body including metallic prostheses, artificial valve prostheses,
 surgical clips, braces, foreign fragments or tattoo