EU-researchers are demonstrating how diet and lifestyle before and during pregnancy, along with infant feeding choices, have a direct impact on the risk of obesity from childhood through to adulthood.
Worldwide, obesity and being overweight are on the rise. Here in Europe, the number of obese people has increased three-fold since the 1980s. As of 2008, over 50 % of men and women in the World Health Organisation’s European Region were considered overweight, and nearly 23 % of women and 20 % of men were listed as obese. In the EU, being overweight affects 30-70 % of the adult population, while obesity affects 10-30 %.
Being overweight/obese also leads to a number of health and societal problems. For example, both are a leading cause of diabetes, high blood pressure and heart disease. In terms of impact on society, as of 2010, the healthcare costs attributable to obesity were estimated to be between 1-3 % of the total healthcare costs in different European countries. More so, the resulting workdays lost and costs of absenteeism caused by overweight/obesity-related health issues is estimated to be €460 billion.
Although scientists generally agree that poor nutrition during early childhood contributes to the overweight/obesity problem, concrete evidence as to its cause is lacking. The EU-funded EarlyNutrition project set out to fill this knowledge gap by investigating the underlying mechanisms of early childhood nutrition and, in doing so, providing practical solutions for preventing obesity.
EarlyNutrition started by combining observational evidence from large, longitudinal cohort studies from around the world with randomised controlled human intervention studies on diet and lifestyle behaviour in pregnancy and early childhood. In addition, the project also studied underlying mechanisms of obesity such as metabolic and epigenetic regulation.
“From this transdisciplinary and international research, the project produced strong evidence that diet and lifestyle before and during pregnancy – as well as infant feeding choices – have a very strong impact on later health and, in particular, on the risk of obesity during both childhood and adulthood,” explains EarlyNutrition Coordinator Berthold Koletzko.
With this understanding, researchers saw that current treatment strategies for controlling weight often fail because they start too late in the game. Contrary to current practice, EarlyNutrition demonstrated that opportunities to reduce the life-long obesity risk only exist before and during the first 1 000 days of life. Thus, the window for effective intervention starts during the 270 days of pregnancy and, by just age three, is already closed.
“A woman’s body weight at the time she becomes pregnant is a very strong predictor of their baby’s health,” says Koletzko. “If a woman is overweight or obese at the time of conception, the child’s lifetime obesity risk is doubled or tripled respectively. Thus, interventions that support approaching a normal body weight at the beginning of pregnancy are particularly important.”
Another key finding is that breastfeeding reduces the obesity risk in both child- and adulthood. For those who formula-feed, the project showed how this preventive effect can be mimicked in bottled milk by simply reducing the protein content to levels similar to breast milk. “Compared to conventional high protein infant milk, feeding a new-born protein reduced infant formula for the first year of life reduces the risk of obesity at early school age by about threefold,” says Koletzko. “This is both the most effective and cost-efficient obesity prevention strategy available today.”
EarlyNutrition’s results are already having an impact. For example, 2016 EU legislation on infant formula is based on the project’s recommendations. “The project’s results and ensuing recommendations continue to be disseminated,” concludes Koletzko. “In addition to influencing regulations here in Europe and around the world, various commercial partners are using the results to bring improved dietetic products to market.”
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