Obesity Related Programming Statements in Materials on Infant Feeding Aimed at Parents in Five European Countries

Abstract

Although the association between early nutrition and later health outcomes known as metabolic programming is well acknowledged amongst researchers, the extent to which this concept is being communicated to parents is not known. The frequency and content of programming statements found in written materials aimed at parents and produced by national governmental bodies, professional and consumer associations, special interest groups and industry were reviewed in five European countries. Stand-alone leaflets, pamphlets and booklets (termed leaflets) targetted towards parents and published from 2000 to 2005 and all issues from 2005 of the most popular monthly parenting magazine providing information on the feeding of healthy infants aged 0-12 months were sourced in each country. Materials targetting older children, mothers or health professionals and focusing on legal and practical aspects or specific diseases were excluded. Altogether 130 documents (England thirty-six, Finland eight, Germany fourteen, Hungary thirty-eight, Spain thirty-four) and 161 articles and notes from sixty magazine issues were screened for nutrition programming statements on nutrients, food items and feeding behaviour in relation to short-term (<5 years), medium-term (5-15 years) and long-term (>15 years) health outcomes of the infant. Statements on non-nutritive substances, non-feeding-related behaviour, vitamin and mineral supplementation and nutrient deficiencies were excluded. In total 638 programming statements were identified. It was found that 76.0 % (n 100) of the leaflets and 41.4 % (n 66) of the magazine articles and notes contained programming statements. The percentage of statements in all materials was highest in Spain (88.6), followed by Hungary (67.3), Germany (50.8), Finland (45.8) and England (42.2) (P<0.001). The most frequently documented health outcomes are listed in the Table. The dominating category for England, Germany and Hungary was allergy, whereas it was risk of infections for Spain and growth and development for Finland. The majority of statements (68.2 %, n 435) did not refer to the duration of the programming effects; of the remaining statements 18.2 % (n 122) referred to short-term, 5.1 % (n 33) to medium-term and 7.5 % (n 48) to long-term programming effects. The most frequently mentioned health outcomes for short-term programming were risk of infections (30.3 %), allergy (16.4 %) and risk of diseases in general (14.8 %), and for long-term programming those mentioned were obesity (22.9 %), the risk of CVD (14.6 %) and health in general (14.6 %).

The Early Nutrition Programming Project (EARNEST): 5 y of successful multidisciplinary collaborative research

“…Studies that aimed to investigate understanding of consumers in the field of early life programming concluded that the concept of early nutrition programming was widely recognized by scientist and governmental bodies; however, there was a lack of representation in respective documents and activities targeted to parents to communicate on early nutrition and for policy documents for professionals (34,35). There were also marked intercountry differences in infant feeding intentions, healthrelated behaviors of mothers, and views of mothers about the relative importance of infant diet on later health (36).…”

Postnatal Growth Patterns in a Chilean Cohort: The Role of SES and Family Environment

“…Therefore, the fattest baby can no longer be viewed as the healthiest baby. While significant progress has been made in promoting breast feeding and encouraging families to delay supplemental bottles and complementary foods in Chile [40] and in many other settings [46, 47], it will be important to change perceptions of families about what a healthy baby looks like and what constitutes optimal growth. As these perceptions are highly linked with cultural norms, this will take a concerted effort on many fronts.…”

EARNEST – the early nutrition programming project

“…There has been excellent progress in studying the consumer perceptions and understanding related to the practical implementation of new knowledge about health effects of maternal and infantile nutrition. Studies in EARNEST Theme 4 have found that the concept of programming by early nutrition is widely acknowledged among scientists and recognised by governmental bodies, but it is not yet reflected in their documents and activities such as in communications aimed directly at parents or in policy documents for professionals (von Rosen‐von Hoewel et al . 2007).…”