In preterm infants, poor postnatal growth is associated with adverse neurocognitive outcomes; conversely, rapid postnatal growth is supposedly harmful for future development of metabolic diseases.ConclusionIn this systematic review, observational studies reported consistent positive associations between postnatal weight or head growth and neurocognitive outcomes; however, there was limited evidence from the few intervention studies. Evidence linking postnatal weight gain to later adiposity and other cardiovascular disease risk factors in preterm infants was also limited.

Human milk (HM) provides all nutrients to support an optimal growth and development of the neonate. The composition and structure of HM lipids, the most important energy provider, have an impact on the digestion, uptake and metabolism of lipids. In HM, the lipids are present in the form of dispersed fat globules: large fat droplets enveloped by a phospholipid membrane. Currently, infant milk formula (Control IMF) contains small fat droplets primarily coated by proteins. Recently, a novel IMF concept (Concept IMF) was developed with a different lipid architecture, Nuturis(®), comprising large fat droplets with a phospholipid coating. Confocal laser scanning microscopy (CLSM), with appropriate fluorescent probes, and transmission electron microscopy were used to determine and compare the interfacial composition and structure of HM fat globules, Concept IMF fat droplets and Control IMF fat droplets. The presence of a trilayer-structured HM fat globule membrane, composed of phospholipids, proteins, glycoproteins and cholesterol, was confirmed; in addition exosome-like vesicles are observed within cytoplasmic crescents. The Control IMF fat droplets had a thick protein-only interface. The Concept IMF fat droplets showed a very thin interface composed of a mixture of phospholipids, proteins and cholesterol. Furthermore, the Concept IMF contained fragments of milk fat globule membrane, which has been suggested to have potential biological functions in infants. By mimicking more closely the structure and composition of HM fat globules, this novel IMF concept with Nuturis(®) may have metabolic and digestive properties that are more similar to HM compared to Control IMF.

Obesity among pregnant women is becoming one of the most important women's health issues. Obesity is associated with increased risk of almost all pregnancy complications: gestational hypertension, preeclampsia, gestational diabetes mellitus, delivery of large-for-GA infants, and higher incidence of congenital defects all occur more frequently than in women with a normal BMI. Evidence shows that a child of an obese mother may suffer from exposure to a suboptimal in utero environment and that early life adversities may extend into adulthood. In September 2009, ILSI Europe convened a workshop with multidisciplinary expertise to review practices and science base of health and nutrition of obese pregnant women, with focus on the long-term health of the child. The consensus viewpoint of the workshop identified gaps and gave recommendations for future research on gestational weight gain, gestational diabetes, and research methodologies. The evidence available on short-and longterm health impact for mother and child currently favors actions directed at controlling prepregnancy weight and preventing obesity in women of reproductive ages. More randomized controlled trials are needed to evaluate the effects of nutritional and behavioral interventions in pregnancy outcomes. Moreover, suggestions that maternal obesity may transfer obesity risk to child through non-Mendelian (e.g. epigenetic) mechanisms require more longterm investigation. Obesity is associated with an increased risk of suboptimal pregnancy outcome, and of maternal and infant death, but most obese pregnant women are quite unaware of the problems they face. Given the incremental costs of these complications, health care budgets will be increasingly stretched (4). In addition, some evidence suggests that a child of an obese mother may suffer from exposure to a suboptimal in utero environment and that these early life adversities may extend into adulthood (5,6). In September 2009, ILSI Europe, a nonprofit scientific foundation, which draws on opinion from academia, government, and industry to identify solutions to topical problems, convened a workshop to review health and nutrition in obese pregnant women, with focus on the health of the child in the longer term. The working party was briefed to discuss and prioritize actions that could lead to improved outcomes in obese pregnancies and protect the health of the mother and the lifelong health of the unborn child. The consensus viewpoint is summarized here. OBESITY AND PREGNANCY OUTCOMEIt is evident that obese pregnant women are at increased risk of maternal death and complications during pregnancy and labor. In the United Kingdom, the latest Confidential Enquiry into Maternal and Child Health (CEMACH) reported that more than half of the deaths from direct or indirect causes during (late) pregnancy or labor were in overweight or obese women (7). Obesity is associated with increased risk of almost all pregnancy complications such as gestational hypertension, preeclampsia, gestational diabetes mellitus (G...

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