Early Nutrition and Later Excess Adiposity during Childhood: A Narrative Review

Abstract

BACKGROUND: Studies on childhood obesity mainly focus on the genetic component and on the lifestyle that may be associated with the development of obesity. However, the study of perinatal factors in their programming effect towards future obesity in children or adults is somewhat more recent and there are still mechanisms to be disentangled. SUMMARY: In this narrative review, a comprehensive route based on the influence of some early factors in life in the contribution to later obesity development is presented. Maternal pre-pregnancy BMI and gestational weight gain has been pointed out as independent determinants of infant later adiposity. Lifestyle interventions could have an impact on pregnant mothers throught epigenetic mechanisms capable of redirecting the genetic expression of their children towards a future healthy weight and body composition and dietary-related microbiome modifications in mothers and newborn might also be related. After birth, infant feeding during the first months of life is directly associated with its body composition and nutritional status. From this point of view, all the expert committees in the world are committed to promote exclusive breastfeeding up to 6 months of age, and to continue at least until the first year of life together with complementary feeding based on healthy dietary patterns such as Mediterranean Diet. KEY MESSAGES: To develop future effective programs to tackle early obesity, is necessary not only by controlling lifestyle behaviors like infant feeding but also understanding the role of other mechanisms like the effect of perinatal factors such as maternal diet during pregnancy, epigenetics or microbiome.

Association of Maternal Pre-Pregnancy Overweight and Obesity with Childhood Anthropometric Factors and Perinatal and Postnatal Outcomes: A Cross-Sectional Study

“…There is currently strong evidence concerning the need to design and promote forthcoming efficient strategies and approaches to limit early obesity. This constitutes a strong demand, which may improve lifestyle behaviors such as infant eating behaviors, contributing also to define the potential impact of other mechanisms, such as the impact of perinatal factors including mothers' nutritional habits during gestation, epigenetics, or microbiome [42]. Interestingly, a recent meta-analysis showed that Mediterranean diet-based interventions may exert a considerable impact on lowering the BMI and decreasing obesity in children and adolescents at ages between 3 and 18 years old [43].…”

Unfavorable nutrient intakes in children up to school entry age: results from the nationwide German KiESEL study

“…Nutrition is a key factor in child development ( 1 ), substantially influencing not only physical but also mental and cognitive health ( 2 ). Moreover, early life nutrition has been found to have long-term effects on health, which include modulating the risk for non-communicable diseases such as obesity, diabetes mellitus, and cardiovascular disease ( 3 , 4 ). At the same time, young children are particularly vulnerable to nutrient deficiencies, as nutrient requirements per kg body weight are high ( 5 ).…”

Nighttime eating during pregnancy and infant adiposity at 6 months of life

“…Different maternal factors (e.g., obesity, gestational weight gain, socioeconomic characteristics) have been identified as influencing infant adiposity ( 1 , 3 ). Lifestyle and nutrition interventions may play a key role in improving maternal metabolic profiles and reducing the risk of obesity in the next generation ( 4 ). Specifically, an optimal diet quality during pregnancy, as well as high adherence to a DASH diet or a Mediterranean dietary pattern has been associated with a better glycemic status and a reduce size and adiposity at birth ( 5 – 8 ).…”