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22nd May 2013: The seeds of many adult diseases are sown in utero and in infancy

A woman’s diet and lifestyle before and during pregnancy and the infant’s diet in early life can affect her baby’s risk of succumbing to disease in later life, according to findings of the British Nutrition Foundation’s (BNF) new Task Force Report, ‘Nutrition and Development: short- and long-term consequences for health’.  The Task Force panel which compiled the report, chaired by Professor Tom Sanders of Kings College London, examined aspects of nutrition and early life development and the impact on the long-term health of an individual.  The findings were presented at a conference for health professionals on 21st May in London.

A summary of the findings can be viewed here "Reducing and Preventing Chronic Disease Risk Through diet and Lifestyle"

Critical Windows
Evidence shows that there are periods of fetal and early life development where the balance of nutrients is particularly important - these are the ‘critical windows’ in an offspring’s development during which his/her future health and development may be ‘programmed’.  Sara Stanner, Science Programme Manager at BNF, explained: “While environment and lifestyle factors may play a part, there is now unequivocal evidence of the biological link between the health status of women and conditions such as obesity, type 2 diabetes and cardiovascular disease in their children in later life.  “There is strong evidence that excessive intake of vitamin A or insufficient consumption of folate/folic acid have clear developmental impacts on unborn children.  However, fetal growth and development may also be affected by more subtle variations in nutrition during ‘critical windows’.”

Birth Weight
The Task Force Report shows that a mother’s weight and the quality of her diet, even pre-pregnancy, can affect the environment in her womb, her baby’s birth weight and her baby’s subsequent health in early life and on into adulthood.  Birth weight and the rate of growth in early life can play a role in longer-term health, for example influencing the risk of obesity in childhood.  About 1 in 6 women (16%) in England are obese at the start of pregnancy and babies born to obese women can sometimes be small and growth-retarded but can also be of an excessive birth weight. Professor Tom Sanders, Chair of the Task Force, said: “Maternal obesity increases the risk of complications in pregnancy, including pre-eclampsia, that can result in a small, growth-retarded baby.

“Evidence suggests that poor fetal growth, especially followed by accelerated growth in infancy, may be associated with long-term adverse consequences for health.  Poor fetal growth may also affect kidney development, making offspring more sensitive to the blood pressure raising effect of salt and, therefore, increasing their risk of cardiovascular disease.”  The Task Force Report highlights that obese mothers are also more likely to have a baby with an excessive birth weight, which is associated with increased risk of obesity in later life for the child.  Task Force panellist Dr Paul Taylor, from Kings College London, highlighted: “Obese women are more likely than women of healthy weight to have gestational diabetes which increases the fuel supply to the baby. This can increase the likelihood of the baby having a very high birth weight and also predisposes the child to developing type 2 diabetes in later life.”

Gut Health
The types of bacteria resident in the large intestine are thought to influence health. BNF’s Task Force Report discusses the implications of this and how a number of factors can affect the type of bacteria present in a young child’s gut, including the profile of the mother’s gut bacteria (sometimes referred to as the gut flora or microbiota), the type of milk feeding adopted and also other aspects of the baby’s diet, as a greater range of foods is introduced.  Speaking at the BNF conference, Dr Anne McCartney, from the University of Reading, said: “All infants have their own unique gut microbiota which is determined, to a large degree, by the environment to which the infant is exposed.  A healthy gut microbiota helps prevent the gut being colonised by harmful microorganisms and is important in establishing a healthy immune system and for the absorption of some nutrients.” 

Asthma and Allergy
Asthma is currently one of the world’s most common chronic diseases and Professor Graham Devereux, from the University of Aberdeen, told the conference: “There is increasing interest in the possibility that the nutrient content of the maternal diet during pregnancy, in particular vitamin E, vitamin D, zinc, selenium and polyunsaturated fatty acids, may influence the development of childhood asthma and allergic disease.  It’s an exciting area of research and there are currently a number of theories proposing the impact of particular nutrients on risk of these conditions.” 

Bone Health
Calcium and vitamin D are well known for being beneficial for bone health. Task Force panellist Dr Nick Harvey, from the MRC Lifecourse Epidemiology Unit, University of Southampton, said: “Low vitamin D concentrations are common in the UK population because of a lack of exposure to sunlight in winter months and poor availability of vitamin D from dietary sources; additionally few people regularly eat oily fish, such as mackerel, salmon and sardines, which do contain this nutrient.  Although pregnant and breastfeeding women are currently advised by the UK Department of Health to take a 10 microgram vitamin D supplement daily, few women actually take vitamin D supplements.”

Brain Development
The Task Force explored maternal diet during pregnancy and its importance for infant brain development, which can also track into later life and influence life chances, economic productivity and cognitive ageing, including risk of dementia.  Speaking at the BNF conference, Professor Marcus Richards, from the Medical Research Council Unit for Lifelong Health and Ageing and the University College London, said: “Energy intake and all nutrients influence brain development, although nutrients of particular importance are: protein, long-chain fatty acids, iron, zinc, copper, iodine, selenium, vitamin A, choline and folate. A healthy, varied diet is important prior to, and throughout, pregnancy to ensure adequate intake of all nutrients is achieved.”

Resources
To help women make positive changes to their health both before and after pregnancy, BNF has produced a handy weekly planner along with useful information and practical advice on healthy eating and physical activity.  The ‘Healthy Life Planner for Woman’ is available to download free from BNF’s website www.nutrition.org.uk, and BNF is encouraging health professionals to direct women in their care towards the resources.

BNF is also working with the Royal College of Midwives (RCM) to help practitioners’ improve their nutrition knowledge.  An online course on healthy eating around pregnancy, specifically produced by BNF, is now available for RCM members.

The BNF’s website (www.nutrition.org.uk) is another useful resource for health professionals and the general public, providing evidence-based dietary and lifestyle information together with an online resource, Nutrition4Baby (www.nutrition4baby.co.uk) designed to deliver practical information for parents, from pre-conception, through pregnancy to breastfeeding and weaning.

Copies of the BNF Task Force report, ‘Nutrition and Development: short- and long-term consequences for health’, are available for £59.99 from www.wiley.com.

This information was supplied by the BNF.  For further information contact Alison Taylor at a.taylor@nutrition.org.uk or 07775 925 452.

 

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