It is the micronutrient deficiencies in the mother, specifically that of vitamin B12, that lay the foundation for adult onset disorders, such as diabetes, in later life. In fact, risk factors, such as smoking or a fatty diet, may only act as precipitators, but it is the mother's health that programmes a baby's future health, C.S. Yajnik, Director, Diabetes Unit, KEM Hospital, Pune, has said.

Dr. Yajnik, diabetologist and researcher, was delivering the keynote address on ‘Experience and prospects for cohorts and biobanks' at the Indo-Swiss symposium on cohorts and biobanks, with special reference to chronic non-communicable diseases, that began here on Friday.

“To put it simply, life begins before birth. A large part of a baby's programming for future health takes place within the first 1,000 days of life from the time conception takes place in the mother's womb. The risk factors which make one predisposed to adult onset disorders are invariably linked to the mother's health. In fact, the health of the adolescent girls of the day determines the health of the future generations,” Dr. Yajnik said.

Maternal health and nutrition should be the focus areas if foetal programming of diabetes is to be tackled and the future generations are to be saved from the risk of Type 2 diabetes, he said.

The intra-uterine environment or the condition inside the mother's womb, which is determined by maternal health, is today recognised as a major determinant of Type 2 diabetes.

Even mild changes in the intra-uterine environment affect the baby's prospects for life by altering the gene functioning.

The Pune Maternal Nutrition Study, led by Dr. Yajnik, is one of the first prospective community-based studies to investigate the relationship between maternal nutrition and foetal growth and its future risk of type 2 diabetes. The study, which started in 1993, is continuing.

The study had observed that nearly 70 per cent of the mothers who were being followed up had low levels of vitamin B12.

“A predominantly vegetarian diet leads to vitamin B12 deficiency. When the children were followed up over six years, we found that the children of mothers who had a high concentration of vitamin B12 during pregnancy had lower insulin resistance, while children of mothers with low vitamin B12 and high levels of folic acid had high levels of insulin resistance,” Dr. Yajnik said.

“Vitamin B 12 deficiency, which seems to be widespread among Indian women, has not received any attention from health policy makers. Supplementation of this vitamin can improve the insulin sensitivity in the offspring and prevent the risk of diabetes in the future generation,” he said.