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British Medical Bulletin 60:5-20 (2001)
© 2001 Oxford University Press
The thrifty phenotype hypothesis
Type 2 diabetes

* Department of Clinical Biochemistry, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK
MRC Environmental Epidemiology Unit, Southampton General Hospital, Southampton, UK
The thrifty phenotype hypothesis proposes that the epidemiological associations between poor fetal and infant growth and the subsequent development of type 2 diabetes and the metabolic syndrome result from the effects of poor nutrition in early life, which produces permanent changes in glucose-insulin metabolism. These changes include reduced capacity for insulin secretion and insulin resistance which, combined with effects of obesity, ageing and physical inactivity, are the most important factors in determining type 2 diabetes. Since the hypothesis was proposed, many studies world-wide have confirmed the initial epidemiological evidence, although the strength of the relationships has varied from one study to another. The relationship with insulin resistance is clear at all ages studied. Less clear is the relationship with insulin secretion. The relative contribution of genes and environment to these relationships remains a matter of debate. The contributions of maternal hyperglycaemia and the trajectory of postnatal growth need to be clarified.
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P. D Gluckman, M. A Hanson, H. G Spencer, and P. Bateson Environmental influences during development and their later consequences for health and disease: implications for the interpretation of empirical studies Proc R Soc B, April 7, 2005; 272(1564): 671 - 677. [Abstract] [Full Text] [PDF] |
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I. C. Mcmillen and J. S. Robinson Developmental Origins of the Metabolic Syndrome: Prediction, Plasticity, and Programming Physiol Rev, April 1, 2005; 85(2): 571 - 633. [Abstract] [Full Text] [PDF] |
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K. Silventoinen, J. Pankow, P. Jousilahti, G. Hu, and J. Tuomilehto Educational inequalities in the metabolic syndrome and coronary heart disease among middle-aged men and women Int. J. Epidemiol., April 1, 2005; 34(2): 327 - 334. [Abstract] [Full Text] [PDF] |
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A M Prentice and S E Moore Early programming of adult diseases in resource poor countries Arch. Dis. Child., April 1, 2005; 90(4): 429 - 432. [Abstract] [Full Text] [PDF] |
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C. M. Boney, A. Verma, R. Tucker, and B. R. Vohr Metabolic Syndrome in Childhood: Association With Birth Weight, Maternal Obesity, and Gestational Diabetes Mellitus Pediatrics, March 1, 2005; 115(3): e290 - e296. [Abstract] [Full Text] [PDF] |
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S. O'Rahilly, I. Barroso, and N. J. Wareham Genetic Factors in Type 2 Diabetes: The End of the Beginning? Science, January 21, 2005; 307(5708): 370 - 373. [Abstract] [Full Text] [PDF] |
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C. J. Rhodes Type 2 Diabetes-a Matter of {beta}-Cell Life and Death? Science, January 21, 2005; 307(5708): 380 - 384. [Abstract] [Full Text] [PDF] |
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B. Schreiner Promoting Lifestyle and Behavior Change in Overweight Children and Adolescents With Type 2 Diabetes Diabetes Spectr, January 1, 2005; 18(1): 9 - 12. [Full Text] [PDF] |
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J. Schwartz and J. L. Morrison Impact and mechanisms of fetal physiological programming Am J Physiol Regulatory Integrative Comp Physiol, January 1, 2005; 288(1): R11 - R15. [Full Text] [PDF] |
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L. D. Longo and W. J. Pearce Fetal cerebrovascular acclimatization responses to high-altitude, long-term hypoxia: a model for prenatal programming of adult disease? Am J Physiol Regulatory Integrative Comp Physiol, January 1, 2005; 288(1): R16 - R24. [Abstract] [Full Text] [PDF] |
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M. G. Ross and M. Desai Gestational programming: population survival effects of drought and famine during pregnancy Am J Physiol Regulatory Integrative Comp Physiol, January 1, 2005; 288(1): R25 - R33. [Abstract] [Full Text] [PDF] |
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M. Desai, D. Gayle, J. Babu, and M. G. Ross Programmed obesity in intrauterine growth-restricted newborns: modulation by newborn nutrition Am J Physiol Regulatory Integrative Comp Physiol, January 1, 2005; 288(1): R91 - R96. [Abstract] [Full Text] [PDF] |
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J. Zhang, R. M. Lewis, C. Wang, N. Hales, and C. D. Byrne Maternal dietary iron restriction modulates hepatic lipid metabolism in the fetuses Am J Physiol Regulatory Integrative Comp Physiol, January 1, 2005; 288(1): R104 - R111. [Abstract] [Full Text] [PDF] |
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