If you ask Michelle Baack, M.D., the fight against obesity and diabetes starts before you are even born.
Dr. Baack is an associate scientist at Sanford Research, a neonatologist at Sanford Health, and an associate professor and the pediatrics department chair at the University of South Dakota Sanford School of Medicine.
She knows her stuff.
For the past 11 years, she and four others in her lab have been working to understand how maternal diabetes or obesity during pregnancy, “can actually reprogram the developing fetus’s genes to increase their risk of heart disease when they’re an adult.”
“We’re trying to stop adult heart disease before a baby’s even born by helping moms to take better care of themselves during the pregnancy,” Dr. Baack said.
Nutrition across generations
Dr. Baack and her team have been using rat and cell models to conduct the study. Over the past decade-plus of research they’ve done, Dr. Baack said they’ve concluded mitochondria, the primary producers of energy, play a role.
“You inherit your mitochondria from your mom,” she explained.
Even in the womb, mitochondria can be damaged by exposure to a diet high in saturated fat or excess sugar.
“And so, we think that this risk is not only passed on to the developing baby, but also to that developing baby’s next generation,” she said.
Dr. Baack said this field of developmental origins of health and disease was developed by epidemiologist Dr. David Barker. Dr. Barker is widely regarded as the pioneer in this field.
Dr. Barker found that babies who were born to moms during periods of either starvation or malnutrition grew up to have heart disease.
“What’s interesting is we’ve gone on to find out that not only babies who have undernutrition, but also babies who have overnutrition have the same actual phenotype, or risk of heart disease, when they’re adults,” she explained.
“There’s been work in the field to kind of understand what the mechanism is. How does this happen? You have to understand how it happens in order to prevent it,” she added.
Which is where Dr. Baack’s rat and cell models really came into play.
Dr. Baack explains that after using rat and cells to see that mitochondria play a role, “we are developing dietary interventions during pregnancy or even pregnancy planning to prevent heart disease in one generation, and also a second generation.”
“People say you are what your mother eats. In our lab, we actually say you are what your grandmother eats,” she said.
This research is incredibly difficult to do with humans. Dr. Baack explained rats are useful because their pregnancies only last 22 days. They can also have 11 babies at a time.
When rats were given a diet high in saturated and trans fats, or a “McDonald’s diet,” as Dr. Baack’s lab refers to it, they both gained excess weight and had higher stillbirth rates.
“We also found that their hearts were affected at birth. Just like babies who were born to moms who have obesity and diabetes during pregnancy, they got better, but then as an adult their hearts were at higher risk of having damage from a heart attack,” she said.
Remember when we talked about the mitochondria earlier? Dr. Baack’s team determined that the mitochondria, the powerhouse of the cell, regulate how much energy your cells can make. The mitochondria can also regulate cell death.
“If your mitochondria don’t work and metabolize well, they don’t make enough energy for your heart to keep going into the aging years. They also increase the risk of damage that the heart can have if it loses oxygen. So, mitochondria are playing a role. We’re looking at strategies during pregnancy to make mitochondria that are inherently healthier,” said Dr. Baack.
Low fat, but balanced
Dr. Baack suggests one of the best things women can do, whether they’re pregnant or planning pregnancy, is follow a balanced low-fat diet.
“While eating less fat is important, it is even more important to eat the right kind of fat. Good fats such as omega-3 long chain polyunsaturated fats (LCPUFA) are important for brain development and overall health. But too much saturated or trans-fat, which is found in highly processed foods, can be particularly unhealthy. Not just for moms, but also for their fetus or breastfeeding baby.
“I do think women need to know that even if you’re not obese, eating a diet that’s high in saturated fats when you’re planning a pregnancy not only affects your health as a pregnant mom, but it can affect you or your baby, and even your baby’s babies,” she said.
Eating less and finding the right balance of fat can be especially helpful for women who have gestational diabetes, or diabetes that is first discovered during pregnancy.
Dr. Baack’s best advice for women with gestational diabetes is, “don’t just look at the carbohydrates you’re eating really seriously. Look at the kinds of fats that you’re eating.
“Saturated fats and trans fats are actually more harmful than the carbohydrates. Those are things we’ve learned from our rat model, and even in human studies.”
- A healthy diet: Your first line of defense against disease
- You can start preventing heart disease at any age
- Eat like Olympians: Sanford advises Team USA on nutrition