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Optimal nutrition in lactating women and its effect on later health of offspring: A systematic review of current evidence and recommendations (EarlyNutrition project).
de Waard, M, Brands, B, Kouwenhoven, SMP, Lerma, JC, Crespo-Escobar, P, Koletzko, B, Zalewski, BM, van Goudoever, JB
Critical reviews in food science and nutrition. 2017;(18):4003-4016
Abstract
BACKGROUND EarlyNutrition ( www.project-earlynutrition.eu ) is an international research consortium investigating the effects of early nutrition on metabolic programming. OBJECTIVE To summarize current evidence and standards, recommendations, guidelines, and regulations on nutrition or supplements in lactating women with emphasis placed on long-term health effects in offspring, including cardiovascular disease, hypertension, overweight/obesity, metabolic syndrome, diabetes, or glucose intolerance. METHODS Medline, Embase, selected databases and websites were searched for documents published between 2010 and 2015. RESULTS Thirteen documents met the inclusion criteria. Effects of maternal long-chain polyunsaturated fatty acid (LC-PUFA) supplementation on overweight/obesity or hypertension in offspring were assessed in 10 studies. One study described the effect of maternal vitamin D supplementation on overweight/obesity, and the remaining 2 studies assessed the effects of maternal probiotic/synbiotic supplementation during lactation on overweight/obesity or metabolic syndrome in their infants. Forty-one documents contained dietary recommendations on various macro- and micronutrients for lactating women, but without consideration of our long-term health outcomes in infants. CONCLUSION Literature on nutrition of lactating women and its effect on their infants' later health with respect to metabolic programming outcomes appeared to be scarce, and focused mostly on supplementation of LC-PUFA's. No recent guidelines or recommendations were available, highlighting the significant research gaps regarding this topic.
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2.
Nutrition of infants and young children (one to three years) and its effect on later health: A systematic review of current recommendations (EarlyNutrition project).
Zalewski, BM, Patro, B, Veldhorst, M, Kouwenhoven, S, Crespo Escobar, P, Calvo Lerma, J, Koletzko, B, van Goudoever, JB, Szajewska, H
Critical reviews in food science and nutrition. 2017;(3):489-500
Abstract
BACKGROUND EarlyNutrition ( www.project-earlynutrition.eu ) is an international research project investigating the effects of early nutrition on metabolic programming. OBJECTIVE To summarize, by performing a systematic review, current standards, recommendations, guidelines, and regulations (hereafter, referred to as documents) on the nutrition of children up to three years of age. Special emphasis was placed on long-term effects of early nutrition, such as the risk of cardiovascular disease, hypertension, overweight, obesity, metabolic syndrome, diabetes, or glucose intolerance. METHODS MEDLINE, selected databases, and websites were searched for documents published between 2008 and January 2013. RESULTS Forty two documents met the inclusion criteria. The strongest and most consistent evidence for a protective, long-term effect was documented for breastfeeding. Also, limiting the intake of sodium and rapidly absorbed carbohydrates, use of a specific meal pattern, reducing the consumption of saturated fatty acids by replacing them with polyunsaturated fatty acids, and lowering the intake of trans fatty acids, seems beneficial. Many documents did not evaluate long-term outcomes of interest to us, or reported insufficient or imprecise data. Inconsistency in recommendations for some outcomes and research gaps were identified. CONCLUSIONS Our findings may serve as a helpful tool in planning further research, preventive actions against important diet-related diseases, and guidelines improvement.
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3.
Recommendations on complementary feeding for healthy, full-term infants.
Alvisi, P, Brusa, S, Alboresi, S, Amarri, S, Bottau, P, Cavagni, G, Corradini, B, Landi, L, Loroni, L, Marani, M, et al
Italian journal of pediatrics. 2015;:36
Abstract
Weaning (or introduction of complementary feeding) is a special and important moment in the growth of a child, both for the family and the infant itself, and it can play a major role in the child's future health. Throughout the years, various weaning modes have come in succession, the latest being baby-led weaning; the timing for introducing foods and the requirements of which sort of nutrient for weaning have also changed over time. Furthermore, the role played by nutrition, especially in the early stages of life, for the onset of later non-communicable disorders, such as diabetes, obesity or coeliac disease has also been increasingly highlighted.Members of Italian Society of Gastroenterology, Hepathology and Pediatric Nutrition (SIGENP) and the Italian Society of Allergology and Pediatric Immunology (SIAIP) Emilia Romagna here propose a practical approach for pediatricians to deal with daily practice. The four main areas for discussion were weaning in relation with the onset of allergic diseases, coeliac disease, diabetes and metabolic syndrome, the nutrition requirements to take into account for assessing the diet of infants under one year of age and about the practice of baby-led weaning focusing on limits and benefits, respectively.
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4.
Development of whole body adiposity in preterm infants.
Griffin, IJ, Cooke, RJ
Early human development. 2012;:S19-24
Abstract
The long-term effects of prematurity, early diet and catch-up growth on metabolic risk and body adiposity are of increasing interest to Neonatologists. Poor growth is known to be associated with poorer neuro-developmental outcome but concern exists that increased rates of "catch-up" (or "recovery") growth may be associated with increased adiposity and the later development of metabolic syndrome. In this manuscript we review the published data on body composition in preterm infants, and present new analyses of body adiposity in preterm infants during the 12-15 months of life, and the effect of growth rate (weight gain) on body adiposity. We conclude that although preterm infants have increased adiposity at term corrected age, they generally have lower body fat than their term peers during the rest of the 12-15 months of life. Although more rapid "catch-up" growth in preterm infants during the first year of life is associated with greater body fatness than slower rates of growth, these higher rates of growth lead to body composition more similar to that of the term-born infant, than do slower rates of growth. Although more studies are needed to determine whether these short-term increases or the longer-term decreases in adiposity modify the risk on chronic diseases such as diabetes mellitus, hypertension or other components of the metabolic syndrome, the widely held concern that preterm babies have greater adiposity than their term peers, and that this is worsened by greater amounts of catch-up growth, are not supported by the available evidence.
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5.
Body composition in newborn infants: 5-year experience in an Italian neonatal intensive care unit.
Giannì, ML, Roggero, P, Piemontese, P, Orsi, A, Amato, O, Taroni, F, Liotto, N, Morlacchi, L, Mosca, F
Early human development. 2012;:S13-7
Abstract
The aim of nutrition in neonatology is to achieve a healthy growth that mimics, both in terms of growth rates and quality of growth, that of a normal fetus of the same gestational age. In addition, providing an optimal amount and quality of nutrients significantly contributes to the attainment of a neurodevelopment similar to that of an infant born at term. Yet, a high risk of developing metabolic syndrome in relation to aggressive nutrition and accelerated postnatal growth velocity has been reported in former preterm infants. Considering the strict interrelationship that exists between early nutrition, growth, and subsequent health, the development of body composition in early infancy, in terms of fat mass, may contribute to the long-term "programming" process. Hence, accurate and non-invasive measurement of infant body composition, which evaluates the quality in addition to the amount of weight gain, represents a useful tool for gaining further insight into the relationship between birth weight or time in utero and future development. Preterm infants, including those born small for gestational age, have been reported to develop an increased and/or aberrant adiposity, in addition to postnatal growth retardation, when assessed at term-corrected age. However, within the first 5 months, preterm infants, either born adequate or small for gestational age, show a recovery of fat mass, and attain fat mass values comparable to those of full-term infants assessed at birth. The metabolic consequences of these findings on the long-term health need to be further clarified.
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6.
Post-discharge nutrition: what does the evidence support?
Greer, FR
Seminars in perinatology. 2007;(2):89-95
Abstract
Although there are no official recommendations for specific nutrient intakes in premature infants after hospital discharge, it is agreed that the goal should be to achieve the body composition and rate of growth of that of a normal fetus of the same postmenstrual age during the entire first year of life. A general recommendation to use the special formulas designed for preterm infants after hospital discharge in place of the formulas for term infants cannot be made from the available evidence at this time. Infants fed human milk after discharge are of the greatest concern as human milk does not in theory meet the requirements for growth in these infants. Such infants should remain on supplemental vitamins and Fe while breastfeeding, and growth as well as serum levels of phosphorus and alkaline phosphatase should be carefully monitored. The increased risk of preterm infants for obesity and the metabolic syndrome secondary to the metabolic/nutritional events early in life (programming) is likely to be small compared with the contribution of other risk factors, such as parental size, weight as an adolescent, and various lifestyle factors such as physical activity.