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Environmental conditions during perinatal development such as maternal undernutrition or overnutrition can program changes in the integration among physiological systems leading to cardio-metabolic diseases. This phenomenon can be understood in the context of the phenotypic plasticity and refers to the adjustment of a phenotype in response to environmental input without genetic change. Experimental studies indicate that fetal exposure to an adverse maternal environment may alter the morphology and physiology that contribute to the development of cardio-metabolic diseases. The significance and role of genetic polymorphism, markers of chronic inflammation, oxidative stress, endothelial dysfunction, leptin synthesis disruption, rennin-angiotensin system in intrauterine cardio-metabolic disease programming are discussed. The study demonstrated that both maternal protein restriction and overnutrition alter the central and peripheral control of arterial pressure and metabolism. Breastfeeding may have beneficial effect on obesity risk later in life in genetically predisposed groups. Understanding the mechanisms which affect health outcomes in the offspring influenced by the macronutrient composition of the maternal diet during pregnancy or lactation may lead to new maternal nutrition recommendations, disease prevention strategies, and therapies that reduce the increasing incidence of cardio-metabolic diseases in children and adults.

About the authors

O. P. Kovtun

Ural State Medical University Russian Ministry of Public Health

Author for correspondence.
ORCID iD: 0000-0002-4462-4179

Olga P. Kovtun - MD, PhD, professor.


Russian Federation

P. B. Tsyvian

Ural State Medical University Russian Ministry of Public Health; Mother and Child Care Research Institute Russian Ministry of Public Health

ORCID iD: 0000-0002-8186-6329

Pavel B. Tsyvian - MD, PhD, professor.


Russian Federation


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