Nutrition and Development

The British Nutrition Foundation is a registered charity. It promotes the wellbeing of society through the impartial interpretation and effective dissemination of scientifically based knowledge and advice on the relationship between diet, physical activity and health.

• Foreword xvTerms of Reference xviTask Force Membership xvii1 Introduction to Early Life and Later Disease 1Dr Siân Robinson1.1 Environmental influences on development 11.2 Links between early life and adult disease 31.3 Biological mechanisms 71.4 Nutrition of mothers and children 81.5 Nutrition of young women today 111.6 Key points 111.7 Key references 122 Normal Growth and Development 13Professor J. Harry McArdle, Dr Laura A. Wyness and Dr Lorraine Gambling2.1 Introduction 132.2 Prenatal development 132.3 Embryo development 162.4 Fetal development 162.5 Fetal development overview 182.6 Birthweight 222.7 Postnatal growth and development 242.8 Growth monitoring (growth charts) 242.9 Secular growth trends 252.10 Canalisation, catch-up and catch-down growth 252.11 Key points 262.12 Recommendations for future research 272.13 Key references 273 Maternal Nutrition and Infant Feeding: Current Practice and Recommendations 28Dr Alison M. Lennox, Professor Judith L. Buttriss and Helena J. Gibson-Moore3.1 Introduction 283.2 Characteristics of pregnant women in the UK 283.3 Current practice and recommendations: pre-pregnancy 323.4 Current practice and recommendations: during pregnancy 353.5 Current practice and recommendations: lactation 413.6 Infant feeding: issues relating to evidence base 423.7 Current practice and recommendations: breastfeeding 433.8 Current practice and recommendations: formula feeding 503.9 Current practice and recommendations: weaning/complementary feeding 533.10 Allergy 673.11 Conclusions 683.12 Key points 693.13 Recommendations for future research 703.14 Key references 70Appendix 3.1: Historical perspective on breastfeeding and artificial feeding 71Breastfeeding 71Artificial infant formula 734 Mechanisms and Pathways of Critical Windows of Development 75Professor Harry J. McArdle and Dr Lorraine Gambling4.1 Introduction 754.2 Embryo stages 754.3 Development of placenta 754.4 Nutritional programming: the effect of nutrition on fetal development 774.5 Potential mechanisms of nutritional programming 804.6 Conclusions 844.7 Key points 854.8 Recommendations for future research 854.9 Key references 855 Perinatal Effects of Sex Hormones in Programming of Susceptibility to Disease 86Professor Richard M. Sharpe5.1 Introduction 865.2 Timing of masculinisation and its body-wide effects 865.3 Disorders of masculinisation 875.4 Male–female differences in disease risk: the potential role of perinatal androgens 885.5 Fetal growth, susceptibility to intrauterine growth restriction and its long-term consequences, including timing of puberty 885.6 Growth hormone–insulin-like growth factor-I axis 905.7 Brain and behavioural effects 905.8 Sex differences in eating disorders, neuronal mechanisms and adipose tissue distribution 905.9 Cardiovascular disease/hypertension 925.10 Kidney disease/hypertension 925.11 The immune system 935.12 Lung development and disease risk 935.13 Effects of maternal diet/obesity and infant feeding choices 935.14 ‘Fetal programming’ and epigenetic mechanisms 955.15 Conclusions 955.16 Key points 955.17 Recommendations for future research 965.18 Key references 966 Neurological Development 97Professor Julian G. Mercer6.1 Introduction 976.2 The developing brain 996.3 Brain energy balance circuits and peripheral feedback signals 1016.4 Nutritional influences on the developing brain 1066.5 Programming mechanisms 1106.6 Nutritional interventions 1126.7 Conclusions 1136.8 Key points 1146.9 Recommendations for future research 1156.10 Key references 1157 Establishing of Gut Microbiota and Bacterial Colonisation of the Gut in Early Life 116Dr Anne L. McCartney7.1 Introduction 1167.2 Acquisition of the gut microbiota 1177.3 Factors affecting the infant gut microbiota (acquisition and development) 1187.4 The gut microbiota of exclusively milk-fed infants 1207.5 The effects of weaning on the infant gut microbiota 1237.6 Potential long-term effects: implications for obesity 1287.7 Conclusions 1287.8 Key points 1287.9 Recommendations for future research 1297.10 Key references 1298 Nutrition and Development: Obesity 130Professor Lucilla Poston8.1 Introduction 1308.2 Inadequate in utero nutrition: a risk factor for obesity in later life? 1308.3 Breastfeeding and risk of obesity in later life 1328.4 Maternal diabetes and obesity: early life determinants of offspring obesity? 1328.5 Interventions to reduce offspring obesity? 1358.6 Interventions in pregnant diabetic women 1368.7 Interventions in obese pregnant women 1378.8 Mechanisms underlying the early life origins of obesity; role of animal studies 1388.9 A central role for disturbance in pathways of appetite regulation 1398.10 Conclusions 1418.11 Key points 1418.12 Recommendations for future research 1428.13 Key references 1429 Nutrition and Development: Type 2 Diabetes 143Dr Susan E. Ozanne9.1 Introduction 1439.2 Relationships between birthweight and type 2 diabetes 1449.3 Postnatal growth 1449.4 Evidence for the role of early nutrition in humans influencing type 2 diabetes risk 1459.5 Evidence for the role of early nutrition in animal models influencing type 2 diabetes risk 1459.6 Conclusions 1489.7 Key points 1489.8 Recommendations for future research 1499.9 Key references 14910 Nutrition and Development: Cardiovascular Disease 150Dr Paul D. Taylor and Professor Thomas A. B. Sanders10.1 Introduction 15010.2 Evidence-based on clinical endpoints 15110.3 Postnatal growth 15210.4 Programming of atherosclerosis 15310.5 Programming of blood pressure 15710.6 Animal models of nutritional manipulation in early life 15810.7 Conclusions 16210.8 Key points 16210.9 Recommendations for future research 16210.10 Key references 16311 Nutrition and Development: Cancer 164Professor Paul Haggarty and Professor Steven Darryll Heys11.1 Cancer incidence and trends 16411.2 Cancer biology 16511.3 Evidence linking early nutrition to cancer 16611.4 Possible mechanisms linking early nutrition to cancer risk 16811.5 Conclusions 17411.6 Key points 17511.7 Recommendations for future research 17511.8 Key references 17612 Nutrition and Development: Bone Health 177Dr Vicki Quincey, Professor Elaine Dennison, Professor Cyrus Cooper and Dr Nicholas C. Harvey12.1 Early life origins of osteoporosis 17712.2 Maternal nutrition in pregnancy 18012.3 Postnatal calcium and vitamin D nutrition 18412.4 Calcium and vitamin D nutrition in older children 18612.5 Vitamin D: problems with defi ning normality 18612.6 Physical activity and bone health in childhood 18812.7 Conclusions 18912.8 Key points 18912.9 Recommendations for future research 19012.10 Key references 19013 Nutrition and Development: Asthma and Allergic Disease 191Professor Graham S. Devereux and Dr Nanda Prabhu13.1 Introduction 19113.2 Pathogenesis 19113.3 Increasing prevalence of asthma and allergic disease 19313.4 Impact of asthma and allergic disease 19313.5 Importance of antenatal and early life influences on asthma and allergic disease 19413.6 Maternal dietary food allergen intake during pregnancy and breastfeeding 19513.7 Breastfeeding and childhood atopic dermatitis and asthma 19813.8 Infant dietary food allergen intake 19813.9 Early life nutrient intake 19913.10 Obesity and childhood asthma and allergic disease 20313.11 Conclusions 20313.12 Key points 20413.13 Recommendations for future research 20413.14 Key references 20514 Nutrition and Development: Early Nutrition, Mental Development and Mental Ageing 206Professor Marcus Richards, Dr Alan Dangour and Professor Ricardo Uauy14.1 The importance of mental development and ageing 20614.2 Maternal diet during pregnancy 20714.3 Breastfeeding 20914.4 Post-weaning diet 21214.5 Conclusions 21314.6 Key points 21414.7 Recommendations for future research 21514.8 Key references 21515 Putting the Science into Practice: Public Health Implications 216Professor Judith L. Buttriss, Sara A. Stanner and Professor Thomas A. B. Sanders15.1 Introduction 21615.2 Summary of the Task Force’s fi ndings for various chronic conditions 21815.3 Diet and lifestyle themes relevant to pregnancy and early life 22815.4 Diet and lifestyle themes relevant to early feeding and weaning 24015.5 Vulnerable groups 24215.6 Diet and lifestyle recommendations 24515.7 Role of health professionals 24715.8 Recommendations 25015.9 Key points 25415.10 Key references 25516 Conclusions of the Task Force 25616.1 Chapter 1 25716.2 Chapter 2 25716.3 Chapter 3 25816.4 Chapter 4 25816.5 Chapter 5 25916.6 Chapter 6 25916.7 Chapter 7 26016.8 Chapter 8 26016.9 Chapter 9 26016.10 Chapter 10 26116.11 Chapter 11 26116.12 Chapter 12 26116.13 Chapter 13 26216.14 Chapter 14 26216.15 Chapter 15 26317 Recommendations of the Task Force 26517.1 Priorities for future research on current practice in relation to early life development 26517.2 Priorities for future research on mechanisms and pathways of early life development 26517.3 Priorities for future research: specifi c diseases 26717.4 Recommendations to key stakeholders 26818 Nutrition and Development: Answers to Common Questions 27318.1 Nutrition and development 27318.2 Developmental programming hypotheses 27318.3 Normal growth 27318.4 How development occurs and factors that can affect it 27418.5 Infl uences of perinatal sex hormone exposure on programming of disease susceptibility 27518.6 Cognitive and neurological development 27618.7 Infl uences of gut microbiota on programming of disease susceptibility 27618.8 Obesity 27718.9 Diabetes 27818.10 Cardiovascular disease 27818.11 Cancer 27918.12 Bone health 28018.13 Allergic diseases and asthma 28118.14 Mental health and cognitive behaviour 28218.15 Dietary and lifestyle advice for early life 28218.16 Policies relating to early life nutrition and development 286Glossary 287References 294Index 342