VIEWPOINT:MEDICAL MEDDLERS

The medical meddlers are at it again. This time they’re trying to programme babies not to get heart attacks later in life.

The fellow behind all this is Professor David Barker and his colleagues of the Environmental Epidemiology Unit at the University of Southampton. They have hypothesized that the quality of a baby’s nourishment before birth and in early infancy, in effect, decides his fate for so called markers of heart disease like raised cholesterol in later life.

Following up on the “fetal origins hypothesis” (for that’s all it is), a group of Finnish researchers got hold of a thousand seven month old babies and gave half a low fat diet, with cholesterol intake less than 200 mg daily. The other half was allowed to eat what they wanted.

After seven months, the researchers noticed that the cholesterol levels of babies in the test group remained low, while those in the control group began going up markedly. Because growth in the two groups proceeded as normal, the researchers concluded their experiment was a success. “Start as you mean to go on,” announced The Lancet, giving the study an implied endorsement.

While The Lancet was championing for Barker, the enthusiasm was a bit more tempered, over at the British Medical Journal. A week earlier, the BMJ had published a bunch of papers that would seem to blast craters in Barker’s proposition. In one, which Barker’s own team carried out, birth weight wasn’t predictive of heart disease in men (although weight at age one was), and sluggish infant growth wasn’t associated at all with risk factors in women. Another study in the journal showed that the risk of heart disease had nothing to do with weight and everything to do with where you live. Heart disease went up when people migrated to areas with high mortality rates from those diseases, suggesting that the problem is environmental.

So, if it isn’t as simple as Barker suggests, why is The Lancet busy pushing low fat diets for babies? And besides, wasn’t the problem supposed to be smallness? If anything, Barker is talking about not restricting infant calories. And of course aren’t they forgetting that people who get heart attacks don’t have high cholesterol (see quote of the month)? Not to mention that researchers have now decided that the real bad guy in heart disease isn’t cholesterol, after all, but homocysteine (see p 7). Heaven only knows what tomorrow’s fall guy will be.

In the fine print, The Lancet notes that we haven’t a clue what this low fat diet with a disturbed fats ratio will do. Actually, it looks like we’re fairly clueless about anything to do with heart disease. As time goes on, only our ignorant meddling becomes clear.