Early Microbe Contact in Defining Child Metabolic Health and Obesity Risk

Abstract

The background to the increase in nutrition-related chronic conditions such as overweight and obesity is more complex than is generally anticipated. Recent scientific data suggest that metabolic disturbances can arise from aberrant gut microbiota, with or without alterations in dietary composition. In particular, early-life dysbiosis induces lasting alterations in the immune and metabolic phe-notype. The compositional development of the indigenous intestinal microbiota, co-evolving with the key regulatory systems of the body, is highly sensitive to the mode of delivery and early feeding, antibiotic use and maternal immune and nutritional state during pregnancy. All these elements interact with the microbiota. Consequently, considerable research interest is currently focusing on the microbial inoculum provided by the feto-maternal interface, along with microbe contact during delivery and through lactation. The early colonisers provide a framework conceptualising the way early-life (pre-, peri-and postnatal) exposures are linked to disease processes and even the pathogenesis of disease. To quote Hippocrates: " All disease begins in the gut " . This holds especially true for nutrition-related diseases, polarised in the detrimental consequences of undernutrition or overnutrition. The impact of the gut microbiota culminates in early infancy, when the immune responsiveness and metabolic phenotype are consolidated. The gut microbiota contributes to nutrition, immunity and metabolism by processing nutrients and regulating their access to and storage in the body, producing chemicals of hormonal nature and controlling the secretion of pro-inflammatory mediators locally and systemically. Another quotation from Hippocrates states that " Natural forces within us are the true healers of disease " . Recent experimental and clinical studies have attracted scientific interest in reprogramming deviations in the gut microbiota. Promoting the predominance of specific non-pathogenic microbes and thereby modifying the intestinal milieu may be taken as an alternative means of attaining prophylactic or therapeutic effects in metabolic and inflammatory conditions. As the critical time window for these to exert their programming effects falls around birth, early initiation of preventive measures is of the essence; influencing the feto-maternal microbe contact may promote the health of the next generation.