Impaired fetal growth does not raise cholesterol levels in adulthood appreciably, according to Rachel Huxley, D.Phil., of the University of Sydney, and her associates.
Proponents of the “fetal origins” hypothesis hold that fetal undernutrition is linked to higher risk of coronary heart disease and related conditions such as high blood pressure, impaired glucose tolerance, and high cholesterol. But it can be argued that there were many methodologic flaws in the collection and interpretation of data supporting this hypothesis. Dr. Huxley and her associates conducted a systematic review of 79 relevant studies involving a total of 74,122 subjects, including 25 studies involving more than 45,000 subjects that were never included in previous examinations of this issue.
They found that for every 1-kg decrease in birth weight, there is only a 2.0-mg/dL rise in cholesterol in later life, which they characterized as a weak link unlikely to affect public health. “Assuming that nutritional intervention in pregnancy could increase birth weight by as much as 100 g, this association would translate into only approximately 0.19 mg/dL lower total cholesterol level,” which would reduce coronary disease risk by less than 0.025%. In contrast, dietary intervention in adulthood can reduce cholesterol level by 15 mg/dL, for a 15% lower CHD risk, they said (JAMA 2004;292:2755–64).