1 Specific Aspects of Childhood Nutrition
Key Words
Metabolic programming of long-term health ·
Developmental origins of adult health ·
Breastfeeding and obesity · Perinatal nutrition ·
Disease risk prevention
Key Messages
- Nutritional and metabolic factors during sensitive,
limited periods of early human development have
a long-term programming effect on health, well-
being and performance in later age, extending into
adulthood and old age - Evidence for early programming effects arises from
in vitro experiments, animal models, retro- and pro-
spective epidemiological studies and controlled in-
tervention trials - Obstetric and paediatric medicine are expected to
achieve a much greater role for the prevention of
long-term disease risks in the population - The important effects on health of early nutrition
programming justify major investments into re-
search and improvement of practice
© 2015 S. Karger AG, Basel
Introduction
Epidemiological studies, numerous animal mod-
els and clinical intervention trials provide ample
evidence that nutritional and metabolic factors
during sensitive, limited periods of early human
development have a long-term programming ef-
fect on health, well-being and performance in lat-
er age, extending into adulthood and old age [1–
3]. Biological programming is defined as lasting
effects on physiology, function, health and dis-
ease risks induced by environmental cues during
limited time periods of early development and
plasticity. While the term ‘programming’ was in-
troduced into the scientific literature by Dörner
[4] already in 1974, the concept has received
broad attention primarily due to retrospective
epidemiological studies published by Barker and
others documenting inverse relationships be-
tween body weight at birth and at 1 year of age,
respectively, and the risks of hypertension, diabe-
tes and coronary heart disease ( fig. 1 ) in adult-
hood [5, 6]. These observations stimulated inten-
sive research that demonstrated powerful long-
term effects of nutrition and growth before and
after birth on later health, performance and dis-
ease risk. The exploration of underlying mecha-
nisms and the resulting effects of metabolic pro-
gramming offers tremendous opportunities for
the early prevention of major health risks already
during pregnancy and infancy, and they could
provide both obstetric and paediatric medicine
with a markedly increased role in promoting the
long-term health of the population. It is likely that
Koletzko B, et al. (eds): Pediatric Nutrition in Practice. World Rev Nutr Diet. Basel, Karger, 2015, vol 113, pp 72–77
DOI: 10.1159/000369235
1.5 Early Nutrition and Long-Term Health
Berthold Koletzko