Nutrition in pregnancy and early childhood and associations with obesity in developing countries

Abstract

Concerns about the increasing rates of obesity in developing countries have led many policy makers to question the impacts of maternal and early child nutrition on risk of later obesity. The purposes of the review are to summarise the studies on the associations between nutrition during pregnancy and infant feeding practices with later obesity from childhood through adulthood and to identify potential ways for preventing obesity in developing countries. As few studies were identified in developing countries, key studies in developed countries were included in the review.Poor prenatal dietary intakes of energy, protein and micronutrients were shown to be associated with increased risk of adult obesity in offspring. Female offspring seem to be more vulnerable than male offspring when their mothers receive insufficient energy during pregnancy.By influencing birthweight, optimal prenatal nutrition might reduce the risk of obesity in adults. While normal birthweights (2500-3999 g) were associated with higher body mass index (BMI) as adults, they generally were associated with higher fat-free mass and lower fat mass compared with low birthweights (<2500 g). Low birthweight was associated with higher risk of metabolic syndrome and central obesity in adults.Breastfeeding and timely introduction of complementary foods were shown to protect against obesity later in life in observational studies. High-protein intake during early childhood however was associated with higher body fat mass and obesity in adulthood.In developed countries, increased weight gain during the first 2 years of life was associated with a higher BMI in adulthood. However, recent studies in developing countries showed that higher BMI was more related to greater lean body mass than fat mass. It appears that increased length at 2 years of age was positively associated with height, weight and fat-free mass, and was only weakly associated with fat mass.The protective associations between breastfeeding and obesity may differ in developing countries compared to developed countries because many studies in developed countries used formula feeding as a control. Future research on the relationship between breastfeeding, timely introduction of complementary feeding or rapid weight gain and obesity are warranted in developing countries.The focus of interventions to reduce risk of obesity in later life in developing countries could include:1. improving maternal nutritional status during pregnancy to reduce low birthweight; 2. enhancing breastfeeding (including durations of exclusive and total breastfeeding); 3. timely introduction of high-quality complementary foods (containing micronutrients and essential fats) but not excessive in protein; 4. further evidence is needed to understand the extent of weight gain and length gain during early childhood are related to body composition in later life.

Prenatal multivitamin supplementation increases birth weight

“…[13][14][15] Some studies indicated increased birth weight by multivitamins might enhance the risk of obesity in adults. 16 In 2015 Dougan et al demonstrated that exposure to prenatal vitamins was not associated with body fatness either in childhood and adulthood. 17 In this study, we could find no association between iron supplementation and birth weight/macrosomia, although a combination of vitamin+iron lead to increased birth weight.…”

Impact of breast-feeding and high- and low-protein formula on the metabolism and growth of infants from overweight and obese mothers

“…Moreover, breast-feeding and introduction of complementary foods adapted to both metabolic and nutritional requirements of growing infants are also envisioned as preventive measures against obesity later in life (5). Alteration of nutrition in a critical period of development in early life can affect the subsequent pattern of growth and development of tissues and organs and may predispose individuals to several disorders later in life (8,9).…”

“…Optimal prenatal nutrition can reduce the risk of obesity in adults by influencing birth weight (5). Moreover, breast-feeding and introduction of complementary foods adapted to both metabolic and nutritional requirements of growing infants are also envisioned as preventive measures against obesity later in life (5).…”

Assessment of Obesity, Presumed and Proven Causes and Prevention Strategies: A Review

“…Food portion sizes; increased food consumption [47][48][49] High intake of total fat, saturated fat and trans fat [50,51] Fast food/Fried foods, [52][53][54][55] Junk food [56][57] -Soft drinks (sodas and sweetened beverages); -high caloric drinks,( sweetened & caffeinated beverages, juices, sugary drinks, juice blends); -Energy drinks [57][58][59][60][61] Alcoholic drinks [62] Overeating, binge eating, mindless eating and excessive snacking [56,62,63] Consumption of High fructose corn syrup and artificial sweeteners [55,59,[62][63][64] Insufficient dietary calcium intake or low dairy intake [67] Low intake of fiber , and Low intake of fruits and vegetables in foods [68,69] Not breastfeeding or short breastfeeding duration ; formula feeding instead of breastfeeding [70][71][72][73][74][75][76][77][78] Intestinal microbes [79][80][81][82][83] Antibiotics in human foods [84][85]…”