Review
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World J Diabetes. Mar 15, 2022; 13(3): 185-202
Published online Mar 15, 2022. doi: 10.4239/wjd.v13.i3.185
Maternal low protein diet and fetal programming of lean type 2 diabetes
Vidyadharan Alukkal Vipin, Chellakkan Selvanesan Blesson, Chandra Yallampalli
Vidyadharan Alukkal Vipin, Chellakkan Selvanesan Blesson, Chandra Yallampalli, Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX 77030, United States
Chellakkan Selvanesan Blesson, Family Fertility Center, Texas Children's Hospital, Houston, TX 77030, United States
Author contributions: Author Contribution: Vipin VA, Yallampalli C and Blesson CS had substantial contributions to conception, synthesis and survey of literature, and contributed to draft the manuscript.
Supported by the National Institutes of Health Grants, No. HL102866, HL58144 and DK114689.
Conflict-of-interest statement: Authors have no conflict of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Chellakkan Selvanesan Blesson, MPhil, MSc, PhD, Assistant Professor, Department of Obstetrics and Gynecology, Baylor College of Medicine, One Baylor Plaza MS: BCM 610, Houston, TX 77030, United States. selvanes@bcm.edu
Received: September 28, 2021
Peer-review started: September 28, 2021
First decision: December 4, 2021
Revised: December 30, 2021
Accepted: February 10, 2022
Article in press: February 10, 2022
Published online: March 15, 2022
Processing time: 167 Days and 20.5 Hours
Abstract

Maternal nutrition is found to be the key factor that determines fetal health in utero and metabolic health during adulthood. Metabolic diseases have been primarily attributed to impaired maternal nutrition during pregnancy, and impaired nutrition has been an immense issue across the globe. In recent years, type 2 diabetes (T2D) has reached epidemic proportion and is a severe public health problem in many countries. Although plenty of research has already been conducted to tackle T2D which is associated with obesity, little is known regarding the etiology and pathophysiology of lean T2D, a variant of T2D. Recent studies have focused on the effects of epigenetic variation on the contribution of in utero origins of lean T2D, although other mechanisms might also contribute to the pathology. Observational studies in humans and experiments in animals strongly suggest an association between maternal low protein diet and lean T2D phenotype. In addition, clear sex-specific disease prevalence was observed in different studies. Consequently, more research is essential for the understanding of the etiology and pathophysiology of lean T2D, which might help to develop better disease prevention and treatment strategies. This review examines the role of protein insufficiency in the maternal diet as the central driver of the developmental programming of lean T2D.

Keywords: Type 2 diabetes; Maternal low protein diet; Fetal programming; Lean diabetes; Developmental origin of health and disease

Core Tip: This is to review the role of maternal low protein diet and its metabolic impact on the offspring leading to lean type 2 diabetes.