Early postnatal nutrition and programming of the preterm neonate

Abstract

Early postnatal nutrition is a vital determinant of adult health; this is particularly true for the infant born prematurely and cared for in a hospital setting such as the neonatal intensive care unit. Human and animal studies support the contribution of postnatal dietary composition and the rate of extrauterine growth to long-term metabolic outcomes. One mechanism by which postnatal nutrition affects long-term outcome is via developmental programming. Programming, or the modulation of gene expression to impart a short-term advantage accompanied by a long-term cost, may be achieved by epigenetic modifications to chromatin. This review summarizes the details of postnatal nutritional content and rate of growth on the development of metabolic disease. The role of epigenetics in developmental programming of the preterm infant is also discussed, with an emphasis on animal models of dietary manipulation and directions in which the field must move in order to formulate effective feeding strategies for the preterm infant.

Frequency of nutritional disorders and their risk factors among children attending 13 nurseries in São Paulo, Brazil. A cross-sectional study

“…28 However, we did not find any association between neonatal risks and being overweight, although neonatal risk was associated with malnutrition and with the set of nutritional disorders, even after controlling for age, hemoglobin level and per capita family income.…”

Epigenetic mechanisms elicited by nutrition in early life

“…2) (54) . While the role of epigenetics in postnatal programming of the neonate remains to be demonstrated, there appears to be a window in which infants are vulnerable (55) . Restoring the microbiota profile with a single bacteria species may be effective in the prevention or treatment of allergic and inflammatory diseases, but only if this occurs during the neonatal period.…”

Effect of intrauterine growth retardation on liver and long-term metabolic risk

“…However, the early exposure to high nutrient intake and rapid weight gain in infancy are associated with metabolic risk in adolescence and adulthood. 96,107,113 Innovative feeding strategies should be finely balanced to guarantee appropriate brain development and catch-up growth, without exposing the infant to postnatal nutritional programming. 113 Future research will test the feasibility and effectiveness of targeted nutritional interventions at different stages of development (from periconceptual time to puberty) in preventing or reversing the epigenetic programming.…”

“…96,107,113 Innovative feeding strategies should be finely balanced to guarantee appropriate brain development and catch-up growth, without exposing the infant to postnatal nutritional programming. 113 Future research will test the feasibility and effectiveness of targeted nutritional interventions at different stages of development (from periconceptual time to puberty) in preventing or reversing the epigenetic programming. 114 Finally, the knowledge of epigenomic markers, such as methylation patterns in specific gene promoters, may enable the identification of individuals who will have increased susceptibility to chronic disease in adulthood because of adverse factors in their early environment.…”