Dr.Goran Ristic ? Paediatric department of Dexeus Hospital (Barcelona)
The World Health Organization (WHO) defines malnutrition as deficiency, excess or imbalance in a person's intake of energy and/or specific nutrients in relation to their requirements. Maternal prenatal nutrition and the child's nutrition in the first 2 years of life (1000 days) are crucial factors in a child?s neurodevelopment and lifelong mental health. Child and adult health risks, including obesity, hypertension, and diabetes, may be programmed by nutritional status during this period. Worldwide, 5.6 million children die before their fifth birthday each year, with 80% of these deaths occurring in sub-Saharan Africa and Asia. Almost half of these deaths occur in children with malnutrition. In addition to an increased frequency of infectious disease, children with malnutrition are at a higher risk of more severe disease and suffer significantly more acute and long-term morbidity and mortality when infected. A well established concept of a ?vicious-cycle? between nutrition and infection has now evolving to encompass dysbiosis and pathogen colonization, enteric dysfunction, dysregulation of nutrients and metabolism, inflammation and bacterial translocation. On the other hand, the prevalence of childhood overweight and obesity has also greatly increased in the last decades. There is evidence that a number of prenatal factors, such as maternal diet, maternal obesity, microbiome, and environmental factors, can affect epigenomic regulation through altered gene and protein expression, leading to a higher risk of the offspring acquiring metabolic-syndrome related diseases. Researchers all around the world are involved and committed to consolidated the existing cohort studies, on-going and novel intervention studies and a basic science programme, with the aim to provide the scientific foundations for evidence-based recommendations for optimal early nutrition that incorporate long-term health outcomes, focusing on four target groups: women before pregnancy, pregnant women, infants (breastfed and formula-fed alike) and young children.