Abstract
Background: A considerable body of evidence accumulated especially during the last decade, demonstrating that early nutrition and lifestyle have long-term effects on later health and disease ("developmental or metabolic programming"). Methods: Researchers involved in the European Union funded international EarlyNutrition research project consolidated the scientific evidence base and existing recommendations to formulate consensus recommendations on nutrition and lifestyle before and during pregnancy, during infancy and early childhood that take long-term health impact into account. Systematic reviews were performed on published dietary guidelines, standards and recommendations, with special attention to long-term health consequences. In addition, systematic reviews of published systematic reviews on nutritional interventions or exposures in pregnancy and in infants and young children aged up to 3 years that describe effects on subsequent overweight, obesity and body composition were performed. Experts developed consensus recommendations incorporating the wide-ranging expertise from additional 33 stakeholders. Findings: Most current recommendations for pregnant women, particularly obese women, and for young children do not take long-term health consequences of early nutrition into account, although the available evidence for relevant consequences of lifestyle, diet and growth patterns in early life on later health and disease risk is strong. Interpretation: We present updated recommendations for optimized nutrition before and during pregnancy, during lactation, infancy and toddlerhood, with special reference to later health outcomes. These recommendations are developed for affluent populations, such as women and children in Europe, and should contribute to the primary prevention of obesity and associated non-communicable diseases.
Original language | English |
---|---|
Pages (from-to) | 93-106 |
Number of pages | 14 |
Journal | Annals of Nutrition and Metabolism |
Volume | 74 |
Issue number | 2 |
DOIs | |
Publication status | Published - 1 Feb 2019 |
Keywords
- Breastfeeding
- Child health
- Developmental programming
- Early childhood
- Early nutrition
- Infancy
- Lifestyle
- Metabolic programming
- Micronutrients
- Obesity
- Preconception
- Pregnancy
- Recommendations
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In: Annals of Nutrition and Metabolism, Vol. 74, No. 2, 01.02.2019, p. 93-106.
Research output: Contribution to journal › Review article › Academic › peer-review
TY - JOUR
T1 - Nutrition during pregnancy, lactation and early childhood and its implications for maternal and long-term child health
T2 - The early nutrition project recommendations
AU - Koletzko, Berthold
AU - Godfrey, K. M.
AU - Poston, Lucilla
AU - Szajewska, Hania
AU - Van Goudoever, Johannes B.
AU - De Waard, Marita
AU - Brands, Brigitte
AU - Grivell, Rosalie M.
AU - Deussen, Andrea R.
AU - Dodd, Jodie M.
AU - Patro-Golab, Bernadeta
AU - Zalewski, Bartlomiej M.
N1 - Funding Information: Work reported herein is carried out with partial financial support from the Commission of the European Communities, the 7th Framework Programme, contract FP7-289346-EARLY NUTRITION and the European Research Council Advanced Grant ERC-2012-AdG – No. 322605 META-GROWTH. This manuscript does not necessarily reflect the views of the Commission and in no way anticipates the future policy in this area. K.M.G. is supported by the National Institute for Health Research through the NIHR Southampton Biomedical Research Centre. L.P. is supported by the National Institute for Health Research and the NIHR Biomedical Research Centre at Guy’s and St. Thomas’ NHS Foundation Trust and King’s College London, UK. J.M.D. is supported by an NHMRC Practitioner Fellowship, Australia. Funding Information: B.K. is supported by the European Commission, H2020 Programmes DYNAHEALTH-633595 and Lifecycle-733206, the European Research Council Advanced Grant META-GROWTH ERC-2012-AdG-no.322605, the Erasmus Plus Programmes Early Nutrition eAcademy Southeast Asia-573651-EPP-1–2016–1-DE-EPPKA2-CBHE-JP and Capacity Building to Improve Early Nutrition and Health in South Africa-598488-EPP-1–2018–1-DE-EPPKA2-CBHE-JP, the EU Interreg Programme Focus in CD-CE111 and the European Joint Programming Initiative Project NutriPROGRAM. Further support has been provided by German Ministry of Education and Research, Berlin (Grant Nr. 01 GI 0825), German Research Council (Ko912/12-1 and INST 409/224-1 FUGG), University of Munich Innovation Initiative. K.M.G. is supported by the National Institute for Health Research through the NIHR Southampton Biomedical Research Centre. L.P. is supported by the National Institute for Health Research and the NIHR Biomedical Research Centre at Guy’s and St. Thomas’ NHS Foundation Trust and King’s College London, UK. J.M.D. is supported by an NHMRC Practitioner Fellowship, Australia. Funding Information: Nutrition and lifestyle before and during pregnancy, lactation, infancy and early childhood have been shown to induce long-term effects on later health of the child, including the risk of common non-communicable diseases such as obesity, diabetes and cardiovascular disease [1–5]. This phenomenon is referred to as “Early metabolic programming of long-term health and disease” or “Developmental origins of adult health and disease”. The available evidence is based on experimental studies in animals, observations from retrospective and prospective observational studies in human cohorts, increasingly from controlled intervention trials. To strengthen the evidence base, researchers from 36 institutions across the European Union, the United States, and Australia collaborate in the European Commission funded “EarlyNu-trition Research Project” (http://www.project-earlynutri-tion.eu) [5, 6]. This international multidisciplinary research collaboration explores how nutrition and metabolism during sensitive time periods of early developmental plasticity can have an impact on cytogenesis, organogenesis, metabolic and endocrine responses as well as epigenetic modification of gene expression, thereby modulating later health. Because of the global escalation in the prevalence of obesity, particular focus has been placed on the developmental origins of adiposity (i.e., body fatness), leading to increasing evidence that early life programming could contribute to the intergenerational transmission of obesity and associated health outcomes [2, 7–9]. The EarlyNutrition Project has received funding from the European Commission (FP7-289346-EARLY NUTRITION), with co-funding provided by the Australian National Health and Medical Research Council (NMHMRC), and project partners to achieve a total budget of 11.1 million Euro. The project is co-ordinated by the Dr. von Hauner Children’s Hospital, LMU – Ludwig-Maximilians-Universität Munich, Germany. The project characterises programming effects and their effect sizes through studying contemporary prospective longitudinal cohort studies, performing randomized controlled intervention trials during pregnancy and infancy, and exploring underlying mechanisms. In order to facilitate translational application, the partnership reviewed available evidence and developed recommendations for dietary practice for women before and during pregnancy and lactation, and for infants and young children, taking long-term health consequences into account. These recommendations are devised for women and children in affluent countries, such as people in Europe. Funding Information: Work reported herein is carried out with partial financial support from the Commission of the European Communities, the 7th Framework Programme, contract FP7-289346-EARLY NUTRITION and the European Research Council Advanced Grant ERC-2012-AdG - No. 322605 META-GROWTH. This manuscript does not necessarily reflect the views of the Commission and in no way anticipates the future policy in this area. K.M.G. is supported by the National Institute for Health Research through the NIHR Southampton Biomedical Research Centre. L.P. is supported by the National Institute for Health Research and the NIHR Biomedical Research Centre at Guy's and St. Thomas' NHS Foundation Trust and King's College London, UK. J.M.D. is supported by an NHMRC Practitioner Fellowship, Australia. Publisher Copyright: © 2019 S. Karger AG, Basel.
PY - 2019/2/1
Y1 - 2019/2/1
N2 - Background: A considerable body of evidence accumulated especially during the last decade, demonstrating that early nutrition and lifestyle have long-term effects on later health and disease ("developmental or metabolic programming"). Methods: Researchers involved in the European Union funded international EarlyNutrition research project consolidated the scientific evidence base and existing recommendations to formulate consensus recommendations on nutrition and lifestyle before and during pregnancy, during infancy and early childhood that take long-term health impact into account. Systematic reviews were performed on published dietary guidelines, standards and recommendations, with special attention to long-term health consequences. In addition, systematic reviews of published systematic reviews on nutritional interventions or exposures in pregnancy and in infants and young children aged up to 3 years that describe effects on subsequent overweight, obesity and body composition were performed. Experts developed consensus recommendations incorporating the wide-ranging expertise from additional 33 stakeholders. Findings: Most current recommendations for pregnant women, particularly obese women, and for young children do not take long-term health consequences of early nutrition into account, although the available evidence for relevant consequences of lifestyle, diet and growth patterns in early life on later health and disease risk is strong. Interpretation: We present updated recommendations for optimized nutrition before and during pregnancy, during lactation, infancy and toddlerhood, with special reference to later health outcomes. These recommendations are developed for affluent populations, such as women and children in Europe, and should contribute to the primary prevention of obesity and associated non-communicable diseases.
AB - Background: A considerable body of evidence accumulated especially during the last decade, demonstrating that early nutrition and lifestyle have long-term effects on later health and disease ("developmental or metabolic programming"). Methods: Researchers involved in the European Union funded international EarlyNutrition research project consolidated the scientific evidence base and existing recommendations to formulate consensus recommendations on nutrition and lifestyle before and during pregnancy, during infancy and early childhood that take long-term health impact into account. Systematic reviews were performed on published dietary guidelines, standards and recommendations, with special attention to long-term health consequences. In addition, systematic reviews of published systematic reviews on nutritional interventions or exposures in pregnancy and in infants and young children aged up to 3 years that describe effects on subsequent overweight, obesity and body composition were performed. Experts developed consensus recommendations incorporating the wide-ranging expertise from additional 33 stakeholders. Findings: Most current recommendations for pregnant women, particularly obese women, and for young children do not take long-term health consequences of early nutrition into account, although the available evidence for relevant consequences of lifestyle, diet and growth patterns in early life on later health and disease risk is strong. Interpretation: We present updated recommendations for optimized nutrition before and during pregnancy, during lactation, infancy and toddlerhood, with special reference to later health outcomes. These recommendations are developed for affluent populations, such as women and children in Europe, and should contribute to the primary prevention of obesity and associated non-communicable diseases.
KW - Breastfeeding
KW - Child health
KW - Developmental programming
KW - Early childhood
KW - Early nutrition
KW - Infancy
KW - Lifestyle
KW - Metabolic programming
KW - Micronutrients
KW - Obesity
KW - Preconception
KW - Pregnancy
KW - Recommendations
UR - http://www.scopus.com/inward/record.url?scp=85060633266&partnerID=8YFLogxK
U2 - https://doi.org/10.1159/000496471
DO - https://doi.org/10.1159/000496471
M3 - Review article
C2 - 30673669
SN - 0250-6807
VL - 74
SP - 93
EP - 106
JO - Annals of Nutrition and Metabolism
JF - Annals of Nutrition and Metabolism
IS - 2
ER -