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Mitsuyoshi SUZUKI1, 2), Satoshi NAKANO1, 2), Yayoi MURANO1), Kenichi MIHARADA2, 3)3)International Research Center for Medical Sciences, Kumamoto University, Kumamoto, Japan2)Division of Molecular Medicine and Gene Therapy, Lund Stem Cell Center, Lund University, Lund, SwedenFetal Programing During the Developmental StageCorresponding author: Mitsuyoshi SuzukiDepartment of Pediatrics, Juntendo University Faculty of Medicine2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, JapanTEL: +81-3-3813-3111　FAX: +81-3-5800-1580　E-mail: msuzuki@juntendo.ac.jp353rd Triannual Meeting of the Juntendo Medical Society “Medical Research Update” 〔Held on May 22, 2021〕〔Received　Aug. 2, 2021〕〔Accepted　Aug. 18, 2021〕J-STAGE Advance published date: Oct. 22, 2021Copyright © 2021 The Juntendo Medical Society. This is an open access article distributed under the terms of Creative Commons Attribution License (CC BY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original source is properly credited. doi: 10.14789/jmj.JMJ21-0020-R　Lifestyle-related diseases have been considered to be caused by genetic factors and lifestyle. In recent years, it has been reported that there is a third factor, based on the developmental origin of health and disease (DOHaD), which involves environmental factors during fetal life and development that are related to health in adulthood and the risk of developing lifestyle-related diseases. In Japan, the percentage of low birth weight (LBW) infants born below 2,500 g has been increasing since around 1980, which seems to correlate with the increase in thinness (body mass index <18.5 kg/m2) of women in their 20s and 30s, inadequate caloric intake during pregnancy, and increasing age at first birth. It is interpreted that infants who acquire a thrifty constitution through this process become relatively overnourished as the nutritional environment improves after birth, leading to an increased risk of developing lifestyle-related diseases. Since it is difficult to correct the acquired frugality after birth, pediatricians need to be aware of the future development of obesity and insulin resistance when monitoring adolescents and young adults born as LBW infants. Physicians caring for adults also need to pay attention to the patient’s birth history, when the patient has a lifestyle-related disease.512Juntendo Medical Journal2021. 67(6), 512-518Special ReviewsLow Birth Weight Associated with a High Risk of Lifestyle-related Diseases: IntroductionLow birth weight (LBW; defined as infants born weighing < 2500 g) infants are known to be at higher risk of developing non-communicable diseases (NCDs) including lifestyle-related diseases such as diabetes mellitus, hypertension, and hyper-lipidemia in adulthood1, 2). One of the major causes of LBW infants is fetal growth restriction (FGR). FGR refers to a condition in which the fetus does not develop to the equivalent of the length of the pregnancy period, and about 70% of cases are due to placental and maternal factors such as placental insufficiency and maternal diabetes or hyperten-Key words: low birth weight infant, nonalcoholic fatty liver disease, epigenetics, insulin-resistance, chronic kidney disease1)Department of Pediatrics, Juntendo University Faculty of Medicine, Tokyo, Japansion. Under these kinds of pathological maternal- fetal environments, exposure to hypotrophic and hypoxic conditions can lead to LBW. In contrast, small for gestational age (SGA) is defined based on the standard values of body size at birth, specifi-cally, described as ‘a child whose birth weight and height are less than the 10th percentile of the stan-dard anthropometric values at birth by length of pregnancy’. According to the definition, FGR and SGA are conceptually different, but FGR is often SGA at birth. Another factor in LBW is preterm birth. Preterm infants often receive multidisciplinary care in the neonatal intensive care unit (NICU) during the early postnatal period, resulting in expo-