Maternal Dietary Quality and Dietary Inflammation Associations with Offspring Growth, Placental Development, and DNA Methylation.

The 'Developmental Origins of Health and Diseases' hypothesis posits that prenatal maternal diet influences offspring growth and later life health outcomes. Dietary assessment has focused on selected nutrients. However, this approach does not consider the complex interactions between foods and nutrients. To provide a more comprehensive approach to public health, dietary indices have been developed to assess dietary quality, dietary inflammation and risk factors for non-communicable diseases. Thus far, their use in the context of placental development is limited and associations with offspring outcomes have been inconsistent. Although epidemiological studies have focused on the role of maternal diet on foetal programming, the underlying mechanisms are still poorly understood. Some evidence suggests these associations may be driven by placental and epigenetic changes. In this narrative review, we examine the current literature regarding relationships between key validated diet quality scores (Dietary Inflammatory Index [DII], Mediterranean diet [MD], Healthy Eating Index [HEI], Alternative Healthy Eating Index [AHEI], Dietary Approaches to Stop Hypertension [DASH], Glycaemic Index [GI] and Glycaemic Load [GL]) in pregnancy and birth and long-term offspring outcomes. We summarise findings, discuss potential underlying placental and epigenetic mechanisms, in particular DNA methylation, and highlight the need for further research and public health strategies that incorporate diet quality and epigenetics.

[Importance of nutrition during pregnancy. Impact on the composition of breast milk]. / Importancia de la nutrición durante el embarazo. Impacto en la composición de la leche materna.

INTRODUCTION: The consumption of a healthy diet is essential during the preconception period, pregnancy and lactation to guarantee maternal-fetal and newborn health. It is important to take into account when configuring the maternal diet that inadequate intakes of vitamins and minerals, as well as a high consumption of foods or beverages with refined sugar increase the incidence of low birth weight infants, while the adequate consumption of micronutrients and carbohydrates (mainly integral) can decrease it. Prenatal consumption of fish is also associated with less intrauterine growth retardation. Maternal nutritional deficits that lead to intrauterine growth retardation can alter the expression of some genes, causing abnormal programming in organ and tissue development. In response, the fetus adapts to this situation of scarcity and may have difficulties adapting to an abundant consumption of food after birth, increasing its propensity to suffer from cardiovascular and metabolic diseases in adult life. After delivery, the nutrition of the infant must be guaranteed through breast milk. There is a relationship between the nutritional status of the mother and the composition of the mother's milk and, therefore, in the supply of nutrients to the infant, which may condition their health. Despite the great importance of an adequate maternal nutritional state, serum deficiencies in vitamins A, E, C, B2, B1, calcium and zinc are observed in pregnant mothers and breast milk, being important to identify and prevent these imbalances before conception and during pregnancy and lactation.

INTRODUCCIÓN: El consumo de una dieta saludable es esencial durante el periodo preconcepcional, embarazo y lactancia para garantizar la salud maternofetal y del neonato. Es importante tener en cuenta al configurar la dieta materna que ingestas inadecuadas de vitaminas y minerales, así como un elevado consumo de alimentos o bebidas con azúcar refinada, aumentan la incidencia de recién nacidos con bajo peso, mientras que el consumo adecuado de micronutrientes y de hidratos de carbono (principalmente integrales) pueden disminuirla. También el consumo prenatal de pescado se asocia con menor retraso del crecimiento intrauterino. Los déficits nutricionales maternos que conducen a un retraso del crecimiento intrauterino pueden alterar la expresión de algunos genes ocasionando una programación anormal en el desarrollo de órganos y tejidos. Como respuesta, el feto se adapta a esta situación de escasez y puede tener dificultad de adaptación ante un consumo abundante de alimentos después del nacimiento, lo cual aumenta su propensión al padecimiento de enfermedades cardiovasculares y metabólicas en la vida adulta. Después del parto, la nutrición del lactante debe estar garantizada mediante la leche materna. Existe una relación entre el estado nutritivo de la madre y la composición de la leche materna y, por lo tanto, el aporte de nutrientes al lactante, lo cual puede condicionar su salud. Pese a la gran importancia que tiene un adecuado estado nutritivo materno, se observan niveles séricos deficitarios en vitaminas A, E, C, B2, B1, calcio y zinc en madres gestantes y en leche materna, por lo que es importante identificar y prevenir estos desequilibrios antes de la concepción y durante el embarazo y la lactancia.

Nutrition in Pregnancy: A Comparative Review of Major Guidelines.

IMPORTANCE: Nutrition patterns in pregnancy play a decisive role in the well-being of the mother and the fetus. OBJECTIVE: The aim of this review was to summarize and compare guidelines and recommendations on nutrition in pregnancy. EVIDENCE ACQUISITION: A descriptive review of major guidelines on antenatal nutrition was conducted, including the most recently published guidelines, namely, by the Australian Government Department of Health (2018); the Canadian Nutrition Working Group and Society of Obstetricians and Gynaecologists of Canada (2016); the World Health Organization (2016); the Institute of Obstetricians and Gynaecologists, Royal College of Physicians of Ireland (2016); the International Federation of Gynecology and Obstetrics (2015); the Academy of Nutrition and Dietetics (2014); and the National Institute for Health and Care Excellence (2008). RESULTS: There is almost universal agreement regarding macronutrient requirements during pregnancy. The WHO, FIGO, and the NICE guidelines make no recommendation on fluid intake. Almost all guidelines state that weight gain during pregnancy should be closely monitored. Folic acid supplementation is universally recommended from the preconception period, but there are controversies regarding other vitamins' supplementation. Multiple micronutrient supplementation could be an option in specific settings according only to the FIGO. Probiotics are not routinely recommended in pregnancy. CONCLUSIONS: There is wide agreement among the reviewed guidelines regarding nutrition in pregnancy, but still there are controversies. Evaluation and classification of influential guidelines can be beneficial for establishing a universal consensus on nutrition during pregnancy, in order to achieve more favorable perinatal outcomes.

Calorie restriction during gestation affects ovarian reserve in offspring in the mouse.

The aim of this study was to investigate the effect of calorie restriction (CR) during pregnancy in mice on metabolism and ovarian function in the offspring. Pregnant female mice were divided into two groups, a control group and a CR group (n=7 in each). Mice in the CR group were fed 50% of the amount consumed by control females from Day 10 of gestation until delivery. After weaning, the offspring received diet ad libitum until 3 months of age, when ovaries were collected. Ovaries were serially cut and every sixth section was used for follicle counting. Female offspring from CR dams tended to have increased bodyweight compared with offspring from control females (P=0.08). Interestingly, fewer primordial follicles (60% reduction; P=0.001), transitional follicles (P=0.0006) and total follicles (P=0.006) were observed in offspring from CR mothers. The number of primary, secondary and tertiary follicles did not differ between the groups (P>0.05). The CR offspring had fewer DNA double-strand breaks in primary follicle oocytes (P=0.03). In summary, CR during the second half of gestation decreased primordial ovarian follicle reserve in female offspring. These findings suggest that undernutrition during the second half of gestation may decrease the reproductive lifespan of female offspring.

Effect of Vitamin D Status during Pregnancy on Infant Neurodevelopment: The ECLIPSES Study.

Vitamin D status during pregnancy is involved in numerous physiological processes, including brain development. In this study, we assess the association between vitamin D status during pregnancy and infant neurodevelopment (cognitive, language, and motor skills). From an initial sample of 793 women (mean age 30.6) recruited before the 12th week of pregnancy, 422 mother-infant pairs were followed up to a postpartum visit. Vitamin D levels were assessed in the first and third trimesters of pregnancy, and socio-demographic, nutritional, and psychological variables were collected. At 40 days postpartum, the Bayley Scales of Infant Development-III were administered to the infants and several obstetrical data were recorded. Independently from several confounding factors, deficient vitamin D levels in the first trimester of pregnancy (<30 nmol/L) predicted a worse performance in cognitive and language skills. Language performance worsened with lower vitamin D levels (<20 nmol/L). In the third trimester, this highly deficient level was also associated with lower motor skills. Vitamin D deficiency was therefore associated with worse neurodevelopmental outcomes. More studies are needed to determine specific recommendations with regard to vitamin D supplementation during pregnancy in order to promote an optimal course for pregnancy and optimal infant neurodevelopment.

Prenatal Amino Acid Supplementation to Improve Fetal Growth: A Systematic Review and Meta-Analysis.

Aberrant fetal growth remains a leading cause of perinatal morbidity and mortality and is associated with a risk of developing non-communicable diseases later in life. We performed a systematic review and meta-analysis combining human and animal studies to assess whether prenatal amino acid (AA) supplementation could be a promising approach to promote healthy fetal growth. PubMed, Embase and Cochrane libraries were searched to identify studies orally supplementing the following AA groups during gestation: (1) arginine family; (2) branched chain (BCAA); (3) methyl donors. Primary outcome was fetal/birth weight. 22 human and 89 animal studies were included in the systematic review. The arginine family, and especially arginine itself, was studied most. Our meta-analysis showed beneficial effects of arginine and (N-Carbamyl) glutamate (NCG), but not aspartic acid and citrulline on fetal/birth weight. However, no effects were reported when isonitrogenous control diet was included. BCAA and methyl donor supplementation did not affect fetal/birth weight. Arginine family supplementation, in particular arginine and NCG, improves fetal growth in complicated pregnancies. BCAA and methyl donor supplementation do not seem to be as promising to target fetal growth. Well controlled research in complicated pregnancies is needed before ruling out AA supplements or preferring arginine above other AAs.

In utero nutritional stress as a cause of obesity: Altered relationship between body fat, leptin levels and caloric intake in offspring into adulthood.

AIMS: Emerging evidence suggests that during gestation the in utero environment programs metabolism and can increase risk of obesity in adult offspring. Our aim was to study how alterations in maternal diets during gestation might alter body weight evolution, circulating leptin levels and caloric intake in offspring, leading to changes in body composition. MATERIALS AND METHODS: We fed gestating rats either a control diet (CD), high fat diet (HFD) or an isocaloric low protein diet (LPD), and examined the repercussions in offspring fed similar diets post-weaning on birth weight, body weight evolution, body composition, insulin sensitivity, glucose tolerance and in the relationship between plasma leptin concentration and caloric intake in offspring during growth and development. KEY FINDS: Offspring from dams fed LPD maintained reduced body weight with greater % lean mass and consumed fewer calories despite having leptin levels similar to controls. On the other hand, offspring from dams fed a HFD were insulin resistant and maintained increased body weight and % fat mass, while consuming more calories than controls despite elevated leptin concentrations. Therefore the uterine environment, modulated primarily through maternal nutrition, modified the relationship between circulating leptin levels, body fat, and caloric intake in the offspring, and dams fed a HFD produced offspring with excess adiposity, insulin resistance, and leptin resistance into adulthood. SIGNIFICANCE: Our data indicates that in utero environmental factors affected by maternal diet program alterations in the set point around which leptin regulates body weight in offspring into adulthood contributing to obesity.

Maternal pregnancy vitamin D supplementation increases offspring bone formation in response to mechanical loading: Findings from a MAVIDOS Trial sub-study.

The Maternal Vitamin D Osteoporosis (MAVIDOS) trial reported higher total body bone mineral content in winter-born infants of mothers receiving vitamin D supplementation [1000 IU/day cholecalciferol] compared with placebo from 14 weeks gestation until delivery. This sub-study aimed to determine whether antenatal vitamin D supplementation altered postnatal bone formation in response to mechanical stimulation. Thirty-one children born to MAVIDOS participants randomised to either placebo (n=19) or cholecalciferol (n=12) were recruited at age 4-5 years. Children received whole body vibration (WBV) for 10 minutes on 5 consecutive days. Fasting blood samples for bone homeostasis, 25 hydroxyvitamin D (25OHD), parathyroid hormone (PTH), and bone turnover markers (Pro-collagen Type 1 N-terminal propeptide, P1NP; Cross-linked C-telopeptide of Type I Collagen, CTX) were collected pre-WBV and on day 8 (D8). Mean changes (D) in P1NP (ng/ml) between baseline and D8 in the vitamin-D intervention and placebo groups were 40.6 and -92.6 respectively and mean changes (Δ) in CTX (ng/ml) were 0.034 (intervention) and -0.084 (placebo) respectively. Between-group DP1NP difference was 133.2ng/ml [95% CI 0.4, 266.0; p=0.049] and ΔCTX 0.05ng/ml (95% CI -0.159, 0.26ng/mL; p=0.62). Antenatal vitamin-D supplementation resulted in increased P1NP in response to WBV, suggesting early life vitamin D supplementation increases the anabolic response of bone to mechanical loading in children.

Prenatal dietary exposures and offspring body size from 6 months to 18 years: A systematic review.

BACKGROUND: In utero dietary exposures may influence childhood obesity. OBJECTIVES: To evaluate the relationship between prenatal dietary exposures and offspring body size from 6 months to 18 years. DATA SOURCES: Articles were identified in PubMed and Web of Science (January 2010-March 2018) using the PRISMA guidelines. Additional studies were identified through a reference review of articles that met the inclusion criteria and related reviews. STUDY SELECTION: Prospective cohort studies that assessed dietary patterns, foods, macronutrients, or beverages during healthy pregnancy and offspring body size. The extraction of articles was done using predefined data fields. SYNTHESIS: One author extracted all information and evaluated bias with the NHLBI's Quality Assessment Tool. RESULTS: A total of 851 research articles were evaluated. Twenty-one studies assessing dietary patterns, macronutrients, foods, and beverages met inclusion criteria. Consumption of a Mediterranean dietary pattern during pregnancy was associated with reduced body size, while refined carbohydrates were associated with offspring obesity. No association was observed between data-driven dietary patterns and offspring body size, as well as a pro-inflammatory diet pattern and offspring body size. Mixed and null findings were observed for the relationship between total carbohydrates, n-3 polyunsaturated fatty acids, protein, sugar-sweetened beverages, and artificially sweetened beverages and offspring body size. CONCLUSIONS: Adhering to a Mediterranean diet and limiting refined carbohydrates during pregnancy may influence offspring body size between 6 months and 18 years. The diverging results that exist between studies highlight the complexity of this topic.

Prenatal High-Fat Diet Rescues Communication Deficits in Fmr1 Mutant Mice in a Sex-Specific Manner.

Using high-throughput analysis methods, the present study sought to determine the impact of prenatal high-fat dietary manipulations on isolation-induced ultrasonic vocalization production in both male and female Fmr1mutants on postnatal day 9. Prior to breeding, male FVB/129 Fmr1 wildtype and female Fmr1 heterozygous breeding pairs were assigned to 1 of 3 diet conditions: standard lab chow, omega-3 fatty acid-enriched chow, and a diet controlling for the fat increase. Prenatal exposure to omega-3 fatty acids improved reductions in the number of calls produced by Fmr1heterozygotes females. Moreover, diminished spectral purity in the female Fmr1homozygous mouse was rescued by exposure to both high-fat diets, although these effects were not seen in the male Fmr1knockout. Prenatal dietary fat manipulation also influenced several other aspects of vocalization production, such as the number of calls produced and their fundamental frequency, aside from effects due to loss of Fmr1.Specifically, in males, regardless of genotype, prenatal exposure to high omega-3s increased the average fundamental frequency of calls. These data support the need for future preclinical and clinical work elucidating the full potential of prenatal high-fat diets as a novel therapeutic alternative forFragile X syndrome.

Role of Maternal Nutrition in the Health Outcomes of Mothers and Their Children: A Retrospective Analysis.

BACKGROUND Low nutrition status of mothers plays an important role in increasing the prevalence of poor pregnancy outcomes. Poor pregnancy outcomes are the most common in the Guangzhou region of China. The objective of the study was to evaluate the role of maternal nutrition in the improvement of health outcomes for mothers and their children in the Guangzhou region of China. MATERIAL AND METHODS In this study, pregnancy medical records of women were analyzed. Data related to questionnaires which had been provided during hospital stays for nutritional consumption were gathered. Demographic characteristics and health outcomes of mothers and their children were recorded. Correlations of health outcomes with maternal nutrition were tested with respect to Z-scores at 95% confidence level. RESULTS Based on the health outcomes of mothers and their children, the study divided participants into 2 groups. The first group was mothers and their children with good health outcomes (live births with weighing ≥2.5 kg; the GHO group, n=130) and the second group was mothers and their children with poor health outcomes (miscarriage or premature birth with weighing less than 2.5 kg; the PHO group, n=70). These results showed positive correlation between financial status of the mother (salaried, P<0.001), maternal body mass index (P=0.001), maternal nutrition (P<0.001), maternal education (in years, P<0.001), and maternal age (P=0.004)) with health outcomes of mothers and their children. CONCLUSIONS The financial status of the mother, maternal nutrition, maternal age, and maternal education were the key determinants for predicting health outcomes of mothers and their children.

Prenatal predictors of objectively measured appetite regulation in low-income toddlers and preschool-age children.

BACKGROUND: Prenatal nutrition impacts offspring appetite regulation in animal models. However, evidence from humans is scarce. OBJECTIVE: To determine associations between indicators of prenatal nutrition and appetite regulation among young children. METHODS: Participants included 454 low-income mother/child dyads (mean child age = 45.2 months [SD = 9.7]). Children's appetite regulation was ascertained with the maternal-reported Child Eating Behavior Questionnaire and objectively assessed using the Eating in the Absence of Hunger protocol. Using hierarchical linear regression, we modelled child appetite regulation measures as a function of prenatal nutrition indicators (child birthweight z scores [BWz, BWz2 ]; maternal pre-pregnancy body mass index [BMI], gestational weight gain [GWG]), adjusted for sociodemographic characteristics. RESULTS: Among girls, higher and lower birthweight were associated with greater energy consumed in the absence of hunger, primarily sweet foods, coeff (95% CI): BWz 0.17 (0.05, 0.28), BWz2 0.15 (0.04, 0.26), but not food responsiveness or food enjoyment. Higher birthweight was also associated with greater satiety responsiveness among girls. Among boys, birthweight was unrelated to measures of appetite regulation. Associations between maternal BMI and GWG and child appetite regulation were inconsistent. CONCLUSIONS: Among low-income girls, but not boys, indicators of adverse prenatal conditions were associated with poor objectively measured appetite regulation during early childhood.

Triplet Male Lambs Are More Susceptible than Twins to Dietary Soybean Oil-Induced Fatty Liver.

BACKGROUND: Litter size affects fetal development but its relation to diet-induced fatty liver later in life is unknown. OBJECTIVES: This aim of this study was to test the hypothesis that litter size influences postweaning fatty liver development in response to soybean oil-supplemented diet. METHODS: Weanling twin (TW) or triplet (TP) male lambs (n = 16) were fed a control diet or 2% soybean oil-supplemented diet (SO) for 90 d. Liver tissue morphology, biochemical parameters, and lipid metabolic enzymes were determined. Hepatic gene expression was analyzed by RNA sequencing (n = 3), followed by enrichment analysis according to Gene Ontology and the Kyoto Encyclopedia of Genes and Genomes. Differentially expressed genes involved in lipid metabolism were further verified by quantitative reverse transcriptase-polymerase chain reaction (n = 4). All data were analyzed by a 2-factor ANOVA, apart from differentially expressed genes, which were identified by the Benjamini-Hochberg approach (q value ≤0.05). RESULTS: SO increased liver triglyceride (by 55%) and nonesterified fatty acid (by 54%) concentrations in TPs (P ≤ 0.05) but not in TWs (P > 0.05). SO also induced a 2.3- and 2.1-fold increase in the liver steatosis score of TPs and TWs, respectively (P ≤ 0.05). Moreover, SO reduced the activity of lipolytic enzymes including hepatic lipase and total lipase in TPs by 47% and 25%, respectively (P ≤ 0.05). In contrast, activities of lipogenic enzymes, including malic enzyme and acetyl coenzyme A carboxylase, were significantly higher in TPs (P ≤ 0.05). Moreover, TPs had higher expression of lipogenic genes, such as FASN (by 45%) and APOB (by 72%), and lower expression of lipolytic genes, such as PRKAA2 (by 28%) and CPT1A (by 43%), compared with TWs (P ≤ 0.05). CONCLUSIONS: TPs have a gene expression profile that is more susceptible to SO-induced fatty liver than that of TWs, which indicates that insufficient maternal nutrient supply at fetal and neonatal stages may increase the risk of nonalcoholic fatty liver disease.

Maternal high-fat diet results in cognitive impairment and hippocampal gene expression changes in rat offspring.

Consumption of a high-fat diet has long been known to increase risk for obesity, diabetes, and the metabolic syndrome. Further evidence strongly suggests that these same metabolic disorders are associated with an increased risk of cognitive impairment later in life. Now faced with an expanding global burden of obesity and increasing prevalence of dementia due to an aging population, understanding the effects of high-fat diet consumption on cognition is of increasingly critical importance. Further, the developmental origins of many adult onset neuropsychiatric disorders have become increasingly clear, indicating a need to investigate effects of various risk factors, including diet, across the lifespan. Here, we use a rat model to assess the effects of maternal diet during pregnancy and lactation on cognition and hippocampal gene expression of offspring. Behaviorally, adult male offspring of high-fat fed dams had impaired object recognition memory and impaired spatial memory compared to offspring of chow-fed dams. In hippocampus, we found decreased expression of Insr, Lepr, and Slc2a1 (GLUT1) among offspring of high-fat fed dams at postnatal day 21. The decreased expression of Insr and Lepr persisted at postnatal day 150. Together, these data provide additional evidence to suggest that maternal exposure to high-fat diet during pregnancy and lactation can have lasting effects on the brain, behavior, and cognition on adult offspring.

Effects of maternal subnutrition during early pregnancy on cow hematological profiles and offspring physiology and vitality in two beef breeds.

This experiment evaluated the effects of subnutrition during early gestation on hematology in cows (Bos Taurus) and on hematological, metabolic, endocrine, and vitality parameters in their calves. Parda de Montaña and Pirenaica dams were inseminated and assigned to either a control (CONTROL, 100% requirements) or a nutrient-restricted group (SUBNUT, 65%) during the first third of gestation. Dam blood samples were collected on days 20 and 253 of gestation, and calf samples were obtained during the first days of life. Pirenaica dams presented higher red series parameters than Parda de Montaña dams, both in the first and the last months of gestation. During early pregnancy, granulocyte numbers and mean corpuscular hemoglobin were lower in Pirenaica-SUBNUT than in Pirenaica-CONTROL cows. Calves from the SUBNUT cows did not show a physiological reduction in red series values in early life, suggesting later maturation of the hematopoietic system. Poor maternal nutrition affected calf endocrine parameters. Newborns from dystocic parturitions showed lower NEFA concentrations and weaker vitality responses. In conclusion, maternal nutrition had short-term effects on cow hematology, Pirenaica cows showing a higher susceptibility to undernutrition; and a long-term effect on their offspring endocrinology, SUBNUT newborns showing lower levels of IGF-1 and higher levels of cortisol.

Influence of mother nutrition during pregnancy and/or lactation on offspring food preference in experimental models / Influência da nutrição materna durante a gestação e/ou lactação na preferência alimentar da prole em modelos experimentais

Abstract Introduction Understanding associations between food preferences and maternal nutrition during pregnancy and lactation could inform efforts to understanding the obesity mechanisms and provide insight to prevent it. Objective: To identify studies that investigated the effects of nutritional interventions during the pregnancy and lactation on the food preferences of offspring. Method: The review was conducted with search for articles in the databases: Scopus, Pubmed, Medline, LILACS, Scielo and Science Direct. Exclusion criteria were used: reviews, human studies, studies with drugs or other substances not related to food. Results: At the end of the search in the databases, 176 references were found. After use the exclusion criteria, reading the titles, abstracts and full articles, were selected 11 articles to compose the review. Conclusion: The selected studies suggested that unbalanced nutrition in early life alters the food preference and neural components related to the consumption of fatty and sugary foods in offspring rodents.

Resumo Introdução O entendimento das associações entre as preferências alimentares e nutrição materna durante a gravidez e lactação poderia colaborar para a compreensão dos mecanismos da obesidade e fornecer informações para prevenir essa infermidade. Objetivo: Identificar estudos que investigaram os efeitos das intervenções nutricionais durante a gravidez e lactação em preferências alimentares dos descendentes. Método: A revisão foi conduzida com busca de artigos nas bases de dados: Scopus, Pubmed, Medline, Lilacs, Scielo e Science Direct. Os critérios de exclusão utilizados: revisões, estudos em humanos, estudos com drogas ou outras substâncias não-alimentares. Resultados: No final da pesquisa nas bases de dados, 176 referências foram encontradas. Depois de usar os critérios de exclusão, lendo os títulos, resumos e artigos completos, 11 artigos foram selecionados para compor a revisão. Conclusão: Os estudos selecionados sugeriram que a nutrição desequilibrada no início da vida altera a preferência alimentar e componentes neurais relacionadas com o consumo de alimentos gordurosos e açucarados em prole de roedores.

[The first 1000 days: an opportunity to reduce the burden of noncommunicable diseases]. / Los primeros 1000 días: una oportunidad para reducir la carga de las enfermedades no transmisibles.

INTRODUCTION: Growth and development are determined by genetic and environmental factors since the very early embryonic life. Long-term health risks, as obesity and other non-communicable diseases (NCD), could be programmed since these early stages. Early life, characterized by plasticity, is the ideal time to intervene and to prevent the risk of suffering a NCD (window of opportunity). Optimal nutrition during the first 1,000 days, since conception to the end of the second year of life, has a determinant role for long-term health. Pregnancy, infancy and toddler periods have specific nutritional requirements. Intestinal microbiota enhances maturation and functioning of the immune system. The interactions between host and intestinal microbiota are potential factors influencing early programming of the intestinal function. Alterations in intestinal colonization are associated to a higher risk of allergic diseases in childhood. Scientific evidence supports the fact that the first 1,000 days are crucial to achieve a better long-term health and represents a strategic period to intervene under the perspective of prevention and public health.

INTRODUCCIÓN: El crecimiento y desarrollo de un individuo está determinado desde la etapa embrionaria por su genética y los factores ambientales con los que interactúa. Los riesgos para la salud infantil y adulta pueden programarse durante las etapas fetal-neonatal y esta programación metabólica precoz puede afectar al desarrollo posterior de enfermedades como la obesidad y otras enfermedades no transmisibles (ENT) asociadas. La vida temprana, por la gran plasticidad que la caracteriza, constituye el momento ideal para intervenir y prevenir el riesgo de ENT (ventana de oportunidad). Una nutrición óptima durante los primeros 1000 días, que comprende desde la concepción hasta los dos años, es clave para la salud a lo largo de la vida. El rápido crecimiento y desarrollo del organismo y sus funciones durante el embarazo, la lactancia y el niño de corta edad conlleva requisitos nutricionales específicos en cada una de estas etapas. La microbiota del tracto gastrointestinal desempeña una labor fundamental en la función y el desarrollo del sistema inmune. Las interacciones entre el hospedador y su microbiota intestinal se consideran factores potenciales en la programación temprana de las funciones intestinales, con una evidencia creciente de que las alteraciones de la colonización bacteriana en el neonato se asocian con un mayor riesgo de enfermedad, incluidas las enfermedades alérgicas. La evidencia científica acumulada muestra que los primeros 1000 días son cruciales para alcanzar el mejor desarrollo y salud a largo plazo, y constituyen un periodo estratégico en términos de prevención y salud pública.