2023-09-19 03:00:00
Diet, environment, care and early experiences play a key role in programming a child’s later health, with significant impacts on physical, cognitive and metabolic development. Nutrition plays a central role and requires parents to be informed and supported.
In October 1944, the German occupying forces imposed an embargo on Amsterdam to repress local resistance actions. Food rations quickly diminished to 1,000 then 500kCal per day. The blockade ended almost eight months later, in May 1945. Children born to pregnant mothers during this “hunger winter” had lower birth weights; As adults, they had a higher risk of type 2 diabetes and obesity than others.
This dramatic episode offers one of the most blatant demonstrations of the importance of the very early stages of life for later health. The mechanism here is epigenetic in nature: the organism adapts to all nutritional, but also environmental and psychosocial factors – the exposome – by modifying the expression of its genes by grafting chemical groups. And these characteristics are transmitted from one generation to the next.
Since then, many scientific studies have confirmed the relationship between low birth weight and cardiovascular or neurodevelopmental diseases, as well as disorders of eating behavior, reproductive functions or the risk of cancer. The quality and quantity of nutritional intake during the very first years of life therefore not only has immediate consequences on the growth and development of the newborn. “These first 1,000 days, which begin at conception and end around the child’s two years, are directly linked to the concept of developmental origin of health and disease (DOHaD). Their consequences on the epigenome, microbiota or neurohormonal messengers have a determining impact in the epidemiology of many chronic non-communicable diseases – cardiometabolic, neurocognitive or immuno-allergic. They should therefore not be the prerogative of pediatricians, neonatologists and nutritionists but should be of interest the entire medical field”insists Dr Jean-Michel Lecerf (nutrition and physical activity department, Longevity Health Prevention Center, Institut Pasteur, Lille).
“Under 2s often consume too much protein”
If this first stage of life constitutes a period of vulnerability, it is also full of opportunities for prevention. Via breastfeeding in the first place: it is beneficial for blood pressure or lipid profile in adolescence, or for reducing the risk of subsequent immunoallergic diseases. Its exclusive practice during the first six months of life must be promoted among parents, the positive perception that the spouse has of it, favoring its practice. “The problems linked to the absence of breastfeeding can often overlap with those of cesarean section, which leads to a less qualitative composition of the child’s microbiota”, comments the nutritionist. Then, parental practices and attitudes allowing new foods to be offered regularly help to build a broad food repertoire during diversification. Be careful though: “Parents tend to project adult nutritional recommendations onto the child even though their needs are specific. Thus, children under 2 years of age often consume too much protein. This excess promotes the growth of adipocytes and muscle cells, often leading to children to be taller but also fatter. Conversely, lipid intake is often controlled by parents even though the majority of them are useful to them, as part of a varied diet rich in essential nutrients “.
And during pregnancy?
Pregnancy is also an important window of opportunity: “we must advise once morest restrictive and exclusion diets, excessive cooking of foods, ultra-processed foods, endocrine disruptors and sweeteners. We must maintain a varied diet, without alcohol, rich in vitamin B9, vegetables and fruits, and omega 3.” The latter have a determining neurodevelopmental role. Appropriate physical activity should not be forgotten either because it directly improves memory and learning abilities as well as the quality of the intestinal microbiota which “without having formal proof, might be beneficial for the unborn child”.
“The father also has a role to play in this story”, summarizes Jean-Michel Lecerf, through its influence on educational and nutritional practices, but not only: epidemiological studies confirm the transmission of epigenetic characteristics from father to child. Thus, those with a diet rich in fats more often have overweight or obese children while a diet deficient in proteins would promote lipid disorders. Studies on smoking or periods of starvation experienced by the father point in the same direction. The scale of the issues introduced by epigenetics and the microbiota in DOHaD should not, however, be a source of stress for parents. “If this notion of prevention through lifestyle of a certain number of later pathologies is interesting, we should not think that everything is at stake in the first years. It is never too late to act. But it is not It’s never too early either.
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