Nutrition Publication

NNIW57 - Primary Prevention by Nutrition Intervention in Infancy and Childhood

Editor(s): Lucas A., Sampson, H.A.. vol. 57

For the 57th Nestlé Nutrition Institute Workshop, which took place in May 2005 in Half Moon Bay, San Francisco, the topic ‘Primary Prevention by Nutrition Intervention in Infancy and Childhood’ was chosen. Early nutrition seems to be involved in the mechanism of control, especially taking into account the role of protein and long-chain polyunsaturated fatty acids (LC-PUFAs).

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Subject Index

Author(s): Subject Index

For the 57th Nestlé Pediatric Nutrition Workshop, which took place in May 2005 in Half Moon Bay, San Francisco, the topic ‘Primary Prevention by Nutrition Intervention in Infancy and Childhood’ was chosen. Early nutrition seems to be involved in the mechanism of control, especially taking into account the role of protein and long-chain polyunsaturated fatty acids (LC-PUFAs).

Concluding Remarks

Author(s): H.A. Sampson

For the 57th Nestlé Pediatric Nutrition Workshop, which took place in May 2005 in Half Moon Bay, San Francisco, the topic ‘Primary Prevention by Nutrition Intervention in Infancy and Childhood’ was chosen. Early nutrition seems to be involved in the mechanism of control, especially taking into account the role of protein and long-chain polyunsaturated fatty acids (LC-PUFAs).

Infant Nutrition and Primary Prevention: Current and Future Perspectives

Author(s): L.A. Sampson

In the past two decades there has been a major change in focus in the fieldof nutrition. Previously, the main interest was meeting nutritional needs; nowthe major emphasis is the impact on health. Indeed, our new understanding ofthe biological effects of nutrition that influence health has revealed theimmense potential for nutrition in primary prevention.

Nutritional Interventions in Infancy and Childhood for Prevention of Atherosclerosis and the Metabolic Syndrome

Author(s): A. Singhal

Atherosclerotic cardiovascular disease (CVD) is the leading cause of deathand disability, and the most important public health priority in the West [1].Yet, despite great progress in its clinical management, the prevalence of CVDcontinues to increase [1]. In the UK alone an estimated 2.7 million people arenow living with coronary heart disease – a number that has risen sharply [1].Consequently, the role of prevention has become a major priority for publichealth policy and future scientific research [1].

Childhood Obesity: Potential Mechanisms for the Development of an Epidemic

Author(s): C. Maffeis

By the year 2000, obesity had already spread to such an extent that theWorld Health Organization defined it the greatest health threat facing theWest. Diabetes, the most common metabolic disorder associated with obesity,will shortly occur as a second epidemic. The increasing prevalence of impairedglucose tolerance and type-2 diabetes, also in adolescents and children sufferingfrom obesity, are the first heralds of this epidemic.

Prenatal and Postnatal Development of Obesity: Primary Prevention Trials and Observational Studies

Author(s): A. Kroke

Since Barker et al. [1] presented the fetal origins hypothesis in 1989 introducingthe concept of the developmental origins of chronic diseases, theinterest in this early life period has increased dramatically. What has beenobserved from developmental biologists for many years became relevant fordisease-related research in clinical medicine, epidemiology, pediatrics, andnutrition research. Many scientists began to study the effects of external andinternal exposures of the fetus or newborn on later health-related outcomes.Initially, cardiovascular diseases (CVDs) were the main focus of research.

Childhood Diabetes Mellitus with Emphasis on Perinatal Factors

Author(s): Z. Laron

Diabetes mellitus (DM) is an ancient syndrome described by Aetios inGreece approximately 500 AD and by Chang Chung-Ching in China around200 AD. From available information it seems that the incidence of diabeteswas low for centuries. In the last half-century technological advances haveenabled on one hand a better understanding of the underlying causes but, onthe other hand, together with changes in lifestyle there has been a dramaticincrease in the incidence of DM [1].

The Gut Microbiota and Potential Health Effects of Intervention

Author(s): B. Björkstén

The biological and medical communities increasingly realize that the microbiotaof the large gut may play important roles in both human health and disease.The perspective of the human colon in health and disease is by no meansa new concept, as already a century ago the Russian scientist, Elia Metchnikoff,indicated the clinical importance of the host colonic microbiota. He also suggestedthat certain live micro-organisms might promote health. Despite this,for many years there was modest interest in this concept among researchersand it is only over the last 10 years that microbial ecology has again become amajor research area.

The Relationship of Breastfeeding to the Development of Atopic Disorders

Author(s): R.S. Zeiger, N.J. Friedman

Allergy prevention efforts must be instituted early in life since thereappears to be a critical period for sensitization to food allergens shortly afterbirth. Some atopic risk factors susceptible to modulation include: (1) intactprotein formula feeding; (2) early introduction of allergenic foods, and (3)environmental tobacco smoke. Since Grulee and Sanford [1] reported in 1939a significant 7-fold reduction in eczema in infants who were breastfed, muchuncertainly has surrounded this potential benefit of breastfeeding. Methodologicaldifferences and design limitations were observed among studies.However, the complex immunological characteristics of breast milk andmaternal–infant interactions may also be at play.

Prevention of Atopy and Allergic Disease: Type of Infant Formula

Author(s): H.A. Sampson

The prevalence of allergy and atopic disorders has been increasing overthe past several decades [1] and consequently investigators have sought tounderstand the reason for this increase and to develop strategies to reversethis trend. A great deal of attention has been focused on early interventionsince most children afflicted with atopic disorders first develop symptomsduring infancy and subsequently develop other atopic symptoms, i.e. the‘atopic march’ [2]. About 70 years ago an article was published suggesting thatbreastfeeding could prevent eczema [3], and since then many studies haveboth supported and refuted this claim. Unfortunately, as discussed elsewherein this symposium, most of these studies have serious methodological flawsmaking the arrival at firm conclusions impossible.

Introduction of Solid Foods

Author(s): A. Von Berg

Feeding guidelines for the prevention of allergic diseases follow the viewthat allergen avoidance leads to a reduction in allergy, which is understood asbeing mediated by sensitization. The role of early feeding in the developmentof allergic disorders has been studied widely. Most of these studies have concentratedon the role of breastfeeding and, in the case of children at a highrisk of allergies, on the role of hypoallergenic formulas as substitutes for orsupplemental to breastfeeding. Less attention has been paid to the role ofsolid food introduction into the baby’s diet and the conditions under whichthis has been done. Nevertheless, all guidelines include some recommendationson the introduction of solid food.

Osteoporosis: Is Primary Prevention Possible?

Author(s): M.S. Fewtrell

Osteoporosis is a major and increasing cause of morbidity and mortality indeveloped countries, and set to become so worldwide in the next fewdecades. Health-care costs are high, principally due to associated hip fractureswhich often result in loss of independence. An individual’s risk of developingosteoporosis is determined by the peak bone mass reached at skeletalmaturity, and the rate of bone loss later in adult life. Historically, strategies toprevent osteoporosis concentrated on reducing bone loss, particularly afterthe menopause in women. However, over the past decade there has been agreater focus on maximizing peak bone mass as an alternative or additionalpotential strategy.

Nutrition and Cancer Prevention: Targets, Strategies, and the Importance of Early Life Interventions

Author(s): S.D. Hursting, M.M. Cantwell, L.B. Sansbury, M.R. Forman

More than one million Americans will be diagnosed with cancer in 2005.This is especially tragic given that many cancers are preventable. Doll andPeto [1] estimated in 1981 that 30% of cancers were due to tobacco use while35% could be attributed to poor dietary practices, and there is mounting evidencethat diet-related conditions, such as obesity, can also greatly influencecancer risk [2]. Some significant progress in tobacco control in the UnitedStates has been made since the 1964 Surgeon General’s Report on Smokingand Health identified cigarette smoking as the cause of lung cancer [3].

Long-Chain Polyunsaturated Fatty Acids in Early Life: Effects on Multiple Health Outcomes

Author(s): M.S. Fewtrell

The efficacy and safety of long-chain polyunsaturated fatty acid (LCPUFA)supplementation of infant formula has become one of the major andmost controversial areas of infant nutrition research over the past 15 years.This paper reviews the current status of research into the effects of LC-PUFAsupplementation during early life on functional outcome, and identifies themajor areas that contribute to ongoing uncertainties in the field. A briefreview of LC-PUFA biochemistry, function and status during fetal life andinfancy is first provided as background.

Perinatal PUFA Intake Affects Leptin and Oral Tolerance in Neonatal Rats and Possibly Immunoreactivity in Intrauterine Growth Retardation in Man

Author(s): L.Å. Hansona, M. Korotkova, M. Hahn-Zoric, S. Zaman, A. Malik, R. Ashraf, S. Amu, L. Padyukov, E. Telemo, B. Strandvik

The importance of the essential fatty acids (EFAs) for early developmenthas been illustrated in numerous studies. The essentiality of linoleic acid(C18:2n-6) and alpha-linolenic acid (C18:3n-3) depends on the fact that they cannotbe produced by animal cells and that they play a major role in numerouscritical tissues and functions. These two fatty acids are also precursors forsuch vital long-chain polyunsaturated fatty acids (PUFAs) of the n-6 and n-3series as arachidonic acid and docosahexaenoic acid [1]. The EFAs also playan important role in the immune system for its protective as well as tissuedamagingcapacities. EFAs are important components in all cell membranesand modify membrane fluidity, function and microenvironment [2]. Thus theyare important for the number and function of cellular receptors, their bindingto ligands and the signal transduction process.has been illustrated in numerous studies. The essentiality of linoleic acid(C18:2n-6) and -linolenic acid (C18:3n-3) depends on the fact that they cannotbe produced by animal cells and that they play a major role in numerouscritical tissues and functions. These two fatty acids are also precursors forsuch vital long-chain polyunsaturated fatty acids (PUFAs) of the n-6 and n-3series as arachidonic acid and docosahexaenoic acid [1]. The EFAs also playan important role in the immune system for its protective as well as tissuedamagingcapacities. EFAs are important components in all cell membranesand modify membrane fluidity, function and microenvironment [2]. Thus theyare important for the number and function of cellular receptors, their bindingto ligands and the signal transduction process.

The Crucial Role of Dietary n-6 Polyunsaturated Fatty Acids in Excessive Adipose Tissue Development: Relationship to Childhood Obesity

Author(s): Fl. Massiera, P. Guesnet, G. Ailhaud

Childhood obesity can be considered a non-infectious epidemic. Accordingto the International Obesity Task Force’s childhood obesity working group‘the epidemic of European Union childhood obesity appears to be acceleratingout of control. Things are worse than our gloomiest predictions’. Consistentwith this statement, cardiovascular risk factors are now becoming‘routinely reported’ among children in many populations. Among the socialtrends favoring childhood obesity, increased energy intake and decreasedenergy expenditure have been substantiated.

Omics for Prevention: Gene, Protein and Metabolite Profiling to Better Understand Individual Disposition to Disease

Author(s): M. Affolter, G.E. Bergonzelli, K. Blaser, S. Blum-Sperisen, B. Corthésy, L.B. Fay, C. Garcia-Rodenas, L.V. Lopes, L. Marvin-Guy, A. Mercenier, D.M. Mutch, A. Panchaud, F. Raymond, C. Schmidt-Weber, A. Schumann, F. Spertini, G. Williamson, M. Kussmann

Diet is evolving from nourishing populations via providing essential nutrientsto improving health of individuals through nutrition. Modern nutritionalresearch focuses on health promotion and disease prevention, on protectionagainst toxicity and stress, and on performance improvement. The concept ofdeveloping nutritionally enhanced or functional food requires: (1) the understandingof the mechanisms of prevention and protection; (2) the identificationof the biologically active molecules, and (3) the demonstrated efficacy ofthese molecules.