Understand the Infant Microbiome and Diabetes Prevention

Understand the Infant Microbiome and Diabetes Prevention

OU Health Harold Hamm Diabetes Center faculty members have begun to uncover some of the most important physiological processes underlying childhood obesity and diabetes risk. The first 1,000 days – identified as one of the 3 pathways to a cure – begins at conception through two years of age. During this time, maternal nutrition influences the development, structure and function of the fetal tissues and organs such as the liver, skeletal muscles, lungs, pancreas, kidneys and brain. One of the critical pathways is the mother's microbiome, which plays a major role in determining the infant microbiome and future health.

Jed Friedman, Ph.D., director of the OU Health Harold Hamm Diabetes Center and Chickasaw Professor of Physiology at the OU Health Sciences Center College of Medicine, is leading a study that seeks to understand how maternal obesity and a high-fat diet alter the microbiome and development of a child’s immune system to be predisposed to obesity and diabetes.

Dr. Friedman states that we're seeing more adverse chronic adult health conditions in children, like obesity, cardiovascular disease, and diabetes. Considering that the typical American diet is high in fat and processed sugars, it’s critical to examine the consequences of maternal diet on infant development. With the new understanding of the infant microbiome and its development, we can solve these challenges with major, lasting change. We can translate this to the community through research and build bridges to help more people.

What is the Microbiome?

A microbiome is a community of microorganisms living together in a particular habitat. In humans, the microbiome consists of the trillions of microorganisms and their genetic material — ten times larger than the human genome — living in your intestinal tract. Every person has a unique microbiome, sometimes referred to as “your second genome” that lives in contact with your bodies own host DNA. The organisms that make up your microbiome, mainly bacteria, are symbiotic (where both the human body and microbiota benefit) and some, in smaller numbers, are pathogenic (promoting disease). They influence functions essential to your overall health, such as digestion, metabolism, immune function, brain health and mood. Understanding how the maternal and early life infant microbiome interacts with our human genetic background and environment is one of the greatest frontiers in modern medicine.

The microbiome assembly in the infant begins early in life, even in the womb. The microbiome assembly essentially writes the program for your early cells. It's responsible for educating cells and providing instructions on how to function. They must give proper instructions to prevent disruption that can cause an inflammatory response – a risk factor for physical and mental disorders throughout life.

New data suggests that a disordered maternal microbiome could significantly affect a child’s health. The microbiota is implicated in various inflammation and metabolism-mediated disorders, including Type 1 and Type 2 diabetes, autoimmune disease, allergies, cardiovascular disease, and non-alcoholic fatty liver disease. It has even been linked to how individuals respond to certain medicines.

The microbiome is dynamic and can change with environmental factors such as diet and stress level. As scientific research begins to uncover more about how the maternal and infant microbiome functions, there's more understanding about creating optimal conditions for a healthy microbiome.

In a healthy person, these "gut bugs" can coexist in harmony, but if things become unbalanced, it can cause inflammation which causes your body to become more susceptible to disease.

"There's been an explosion in our understanding of the human microbiome, so now that we know it exists and that it can be disrupted and that nutrition is a key player in how this develops, that's a real target for us scientifically and therapeutically,” said Dr. Friedman.

How Does the Microbiome Develop?

Research suggests that the foundations of the microbiome begin while we're still in the womb. The mother's unique microbiome is transferred to the fetus in preparation for a much larger microbial transfer or acquisition during delivery through the birth canal, skin-to-skin and breast milk, which forms an integral part of our unique physiological identity. Many factors influence the types of bacteria that live and flourish in the gastrointestinal (GI) tract, such as the genetics and health of the parents and the mother's diet and stress level during pregnancy The specific microorganisms that the infant is exposed to depend entirely on the species found in the mother, and later the environment.

Environmental exposures such as diet and toxins can change the microbiome from birth and as you grow to be either beneficial or detrimental to health. Some environmental exposures like those found in foods, household exposures such as pets or chemicals, or stressful events or illnesses, are difficult to change. However, some are factors we can modify or control, such as our lifestyle behaviors – particularly diet.

As we discover more about how diet and gene-environment interactions control the acquisition and persistence of the microbiome and disease pathways – an important step to establish causality rather than just correlation – we can implement steps to create a foundation of health rather than disease.

Pathway to a Cure

Studies show a strong association between maternal obesity and diabetes and childhood obesity. Dr. Friedman notes that this connection is of particular concern because about 50 to 60 percent of women enter pregnancy either overweight or obese. In addition, up to 20 percent of pregnant women develop Gestational Diabetes Mellitus (GDM), which can lead to diabetes in childhood and the mother converting to Type 2 diabetes within 5 to 10 years.

Since we know that a fetus gets its microbiome imprint while in utero and receives bacteria during birth and lactation, we can influence a mother’s health through her diet and improve her microbiome to ultimately improve her baby’s health. The first 1,000 days are a time of tremendous potential and enormous vulnerability.

The research at HHDC shows promise to prevent Type 1 and Type 2 diabetes by influencing the microbiome of the mother and child during the first 1,000 days to lay the foundation for lifelong health. Molecular surveys of the microbiome and infant outcomes will be used to identify biomarkers (a measurable bodily characteristic that may be a sign of predisposition to disease). These biomarkers and their mechanistic underpinnings will provide important diagnostic value or predictive information of long-term health outcomes.

"We know now that many things have early origins in the first 1000 days. We develop our metabolism patterns in the womb and during lactation that not only affect our growth, but our brain development, our fat cells, and our immune system,” said Dr. Friedman. “So, if we can understand more about those triggers and why that's become a pathway to juvenile and eventually adult diseases, we'll have a real shot at preventing and disrupting this across the generational cycle."

Learn more about the first 1000 days and the HHDC research and make a donation to diabetes prevention research.