Does substrate availability in early childhood affect later health and development?

Abstract

The rapid growth, development and organ differentiation during early human development depend on an adequate and balanced substrate availability. It is well known that early nutrition has short term effects (e.g. on growth), and that marked metabolic imbalances in infancy (e.g. hypoglycaemia, phenylketonuria) have long term effects on child development. More recent studies indicate that also variations of metabolic conditions within the normal range, which occur during sensitive periods of early human development, may have marked long term effects on later prognosis and disease risks in adulthood. This metabolic programming was demonstrated in epidemiologic studies indicating close relationships between indicators of early growth and the disease incidence and the mortality of coronary heart disease in late adulthood. Long term effects of infant feeding on immunological functions are indicated by the effects of infant feeds on later prevalence of allergic disease and by the difference in morbidity for diabetes mellitus, Crohn's disease and malignant lymphoma between previously breast fed and formula fed infants. An improved understanding of the cellular and molecular mechanisms that modulate these observed long term effects is required to enable effective preventive interventions. Already the available information indicates a great potential for actively improving long term child health and development by an improved substrate supply during pregnancy and infancy.