PREGNANCY

Early life nutrition – setting the stage for a lean future

By: Brightest Editors

April 25, 2017

The number of overweight and obese children has increased to greater than 42 million globally; these children live in increasingly low and middle income countries [1] and are very likely to grow into obese adults [2]. If an obese woman becomes pregnant, her children have a higher risk of becoming obese themselves [3]. To stop the prevalence of obesity, it is important to break this cycle. Even though the reasons for the increased rates of obesity are not entirely understood, nutrition in early life has been identified as an important step in reducing obesity.

In addition to increased maternal body weight, the lack of essential nutrients during pregnancy and nursing can lead to the development of obesity [4]. Children born to mothers with low folate levels are more likely to be overweight or obese at approximately 6 years of age [5]. Studies have shown that folate works closely with other essential nutrients such as vitamin B12 in the body, therefore, it is not surprising that supplementation with a mix of these nutrients plays a role in changing factors that lead to the development of obesity [6]. What’s more, research shows that pre-pregnancy obesity and excessive weight gain during pregnancy may make it more difficult to breastfeed [8]. This is important as breastfeeding may protect the infant from becoming obese later in life [9].

Being over- or under-nourished in early life can predispose a child to obesity, so finding the right balance is crucial. A diet rich in essential nutrients with a moderate amount of calories in line with general dietary guidelines is a promising way to provide mother and baby with what they need [10] to maintain a healthy body weight. However, experience shows that most people do not follow dietary recommendations as they tend to over-consume foods that supply energy without essential nutrients or “empty calories,” while not eating enough fruits, vegetables, whole grains and milk [11]. This is true for many parts of the world, as a recent study reported 58 percent to 88 percent of adults do not eat enough fruits and vegetables [12].

It is not surprising that a significant number of pregnant and nursing women or women who are planning to become pregnant have sub-optimal intakes of one or more essential nutrients. For example, iron deficiency during pregnancy affects 15 to 20 percent of pregnant women worldwide, while iodine deficiency is even more prevalent, particularly in Europe (44 percent), Africa (40 percent) and Asia (32 percent)[13]. What’s more, 15 percent of pregnant women in low income countries were reported to be deficient in vitamin A [14], and a recent review in Japan, North America, Europe and Australia showed a significant number of pregnant women had low intakes for a range of micronutrients including folate and vitamin D [15].

Given the importance of essential nutrients during this crucial time, women of childbearing age need to find ways to improve their diet. It has been shown that pregnant women who consumed fortified cereals regularly had significantly higher intakes of folate, iron, zinc, calcium, as well as vitamins A, C, D and E and reduced their risk of inadequate nutrient intakes by up to 90 percent [16]. If consumption of vitamins and minerals during pregnancy is low, supplementation may prove to be an important contribution in the fight against childhood obesity.

References

  1. World Health Organization. Childhod overweight and obesity. Global Strategy on Diet, Physical Activity & Health 2017  [cited 2017 22.03.2017]; Available from: http://www.who.int/dietphysicalactivity/childhood/en/.
  2. Daniels, S.R., The consequences of childhood overweight and obesity. Future Child, 2006. 16(1): p. 47-67.
  3. Catalano, P.M., Obesity and Pregnancy—The Propagation of a Viscous Cycle? The Journal of Clinical Endocrinology & Metabolism, 2003. 88(8): p. 3505-3506.
  4. Rao, K.R., I.J.N. Padmavathi, and M. Raghunath, Maternal micronutrient restriction programs the body adiposity, adipocyte function and lipid metabolism in offspring: A review. Reviews in Endocrine and Metabolic Disorders, 2012. 13(2): p. 103-108.
  5. Wang, G., et al., Association between maternal prepregnancy body mass index and plasma folate concentrations with child metabolic health. JAMA Pediatrics, 2016. 170(8): p. e160845.
  6. Cordero, P., et al., Perinatal maternal feeding with an energy dense diet and/or micronutrient mixture drives offspring fat distribution depending on the sex and growth stage. Journal of Animal Physiology and Animal Nutrition, 2015. 99(5): p. 834-840.
  7. Vidakovic, A.J., et al., Maternal plasma PUFA concentrations during pregnancy and childhood adiposity: the Generation R Study. The American Journal of Clinical Nutrition, 2016. 103(4): p. 1017-1025.
  8. Hilson, J.A., K.M. Rasmussen, and C.L. Kjolhede, Excessive Weight Gain during Pregnancy Is Associated with Earlier Termination of Breast-Feeding among White Women. The Journal of Nutrition, 2006. 136(1): p. 140-146.
  9. World Health Organization. Exclusive breastfeeding. e-Library of Evidence for Nutrition Actions (eLENA) 2014  23.06.2014]; Available from: http://www.who.int/elena/titles/exclusive_breastfeeding/en/.
  10. Cox, J.T. and S.T. Phelan, Nutrition During Pregnancy. Obstetrics and Gynecology Clinics of North America, 2008. 35(3): p. 369-383.
  11. Krebs-Smith, S.M., et al., Americans Do Not Meet Federal Dietary Recommendations. The Journal of Nutrition, 2010. 140(10): p. 1832-1838.
  12. Murphy, M.M., et al., Global assessment of select phytonutrient intakes by level of fruit and vegetable consumption. British Journal of Nutrition, 2014. FirstView: p. 1-15.
  13. Black, R.E., et al., Maternal and child undernutrition and overweight in low-income and middle-income countries. The Lancet, 2013. 382(9890): p. 427-51.
  14. World Health Organization, Global prevalence of vitamin A deficiency in populations at risk 1995–2005, in WHO Global Database on Vitamin A Deficiency. 2009: Geneva.
  15. Blumfield, M.L., et al., Micronutrient intakes during pregnancy in developed countries: Systematic Review and Meta-Analysis. Nutrition Reviews, 2013. 71(2): p. 118-132.
  16. Snook Parrott, M., et al., Maternal cereal consumption and adequacy of micronutrient intake in the periconceptional period. Public Health Nutrition, 2009. 12(08): p. 1276-1283.
  17. Haider, B.A. and Z.A. Bhutta, Multiple-micronutrient supplementation for women during pregnancy. Cochrane Database of Systematic Reviews, 2015(11).

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