Early Life Nutrition and Lifelong Health - Derbyshire Local Medical ...

BMA Board of ScienceThere is another paradox in the data from the older cohorts, which needs to be investigated. HighBMI is a risk factor for cardiovascular disease and diabetes, but the relationships of infant weightgain to adult BMI and to adult disease are in opposite directions. The key to understanding thismay be to obtain better information about body composition in infancy. The Delhi study showedthat infant BMI gain was more strongly related to adult lean mass than to adult adiposity, whileBMI gain in later childhood was strongly related to adult adiposity. 19, 236 Infant weight gain inHertfordshire was associated with taller adult height and bone mineral content, 237 which wouldalso be associated with greater lean mass.Key messageSeveral studies of cardiovascular risk factors in children have shown higher blood pressure inthose who gained more weight during infancy. On the other hand, studies of adults haveshown a lower risk of cardiovascular disease and type 2 diabetes in those who gained moreweight during infancy. These apparently paradoxical findings need to be investigated further.There remain many unanswered questions. Most people would agree that normal infant weightgain should be protected, but should it be actively promoted or should catch-up or rapid weightgain be actively prevented? Is the answer to this question the same in all populations? And howmodifiable, in any case, is the weight gain of a healthy well-nourished and demanding infant?These are important questions, because infancy is an ‘accessible’ stage of life when optimalnutrition could have lifelong benefits. In developing countries, paediatricians generally try topromote catch-up weight gain and linear growth in small babies. There is good evidence that thisreduces infant mortality, improves growth and development and has lasting benefits on educationand work attainment. 3, 125, 238 In more affluent countries such as the UK, getting infant nutritionright is likely to be an important element of efforts to prevent obesity and common causes ofdeath and disability such as cardiovascular disease and diabetes.Key messageGetting infant nutrition right has lasting benefits for growth and development, and isimportant in the prevention of obesity and chronic disease in adult life.48Early life nutrition and lifelong health