Nutrition in a lifecourse perspective: From molecular aspects to public health approaches

Abstract

The most recent numbers from the Global Burden of Disease study, show that among children aged 0−9 years, the three leading detailed risk factors for attributable disability-adjusted life years are all related to malnutrition (Murray et al., 2020). Addressing population diet is therefore at the core of health promotion and public health with huge potential to improve population health.How can these challenges to public health be addressed? There has been increasing attention to the importance of applying a lifecourse perspective within public health, and several countries and the World Health Organization (WHO) have endorsed this approach (Public Health England, 2019;WHO Europe, 2018). The lifecourse approach takes into account that environmental exposures including biological, physical, social and behavioural factors, as well as life experiences, throughout the entire life span, influence health outcomes in current and future generations (Fine & Kotelchuck, 2010;Herman et al., 2014).Second, it acknowledges sensitive periods and 'critical windows' of development when environmental factors can profoundly impact longterm health and disease risk in adulthood (Gluckman et al., 2016;Hanson & Gluckman, 2014). Preconception, pregnancy, infancy, childhood and adolescence are periods of biologic plasticity when the developing body is particularly sensitive to its surrounding environment. The lifecourse approach also acknowledges that differences in health across populations, genders, socioeconomics, caste/ethnicity, geography, and their intersections cannot be explained solely by genetics or individual choice, but rather reflect the impact of broader societal and environmental conditions over time (Fine & Kotelchuck, 2010;Herman et al., 2014).Adequate and balanced nutrition is a cornerstone in a lifecourse approach to health, playing a pivotal biological role by providing essential energy and nutrients for developmental processes and overall well-being. Diet, however, intertwines intricately with every facet of society, ranging from individual choices to global politics. This complexity involves drivers at structural levels such as price and availability, and individual level, such as the level of knowledge, which contribute to both inequalities and inequities.