Infant & toddler nutrition

In the late 1980s, Barker & Osmond first described the developmental origins of health and disease through ecological studies that showed correlations between place of birth and the risk of death fromcoronary heart disease and between the risk of death ininfancy and coronary heart disease mortality^3-5. Following this, retrospective cohort studies, that used health records from a population of 16,000 men and women born in Hertfordshire in the UK between 1911 and 1930, found that lower birthweight was associated with increased coronary mortality⁶. Further studies that followed up the men aged 64–75 years in this same Hertfordshire cohort showed an inverse association between weight at birth and blood pressure⁷, type-2 diabetes⁸ and the insulin resistance syndrome⁹. In the US, data on birthweight from 70,297 women showed that among full-term singletons, and after adjustment for adult body mass index, the risks of coronary heart disease and stroke were associated with weight at birth. A lower weight at birth was also associated with higher blood pressure in adulthood¹⁰. These initial studies into the associations between early life health parameters and adulthood disease were only the start of what continues to be a fascinating area of research.

It is now well accepted that numerous early life exposures can impact long-term health, however early life nutritional exposures are particularly significant and the most well-researched. By providing good nutrition during pregnancy, infancy, and toddlerhood, parents/guardians can make a significant difference to a child’s future eating habits as well as their long-term physical & mental health. The impact of early life nutrition can be summarized below under the headings, ‘Behavioural’ and ‘Physiological’.

• Influences feeding habits¹¹
• Impacts on taste preference^12,13
• Affects food texture preferences^14,15

• Metabolic – processes may be set during early life, determining how the body learns to break down, absorb and use nutrients for lifelong growth and development¹⁶.
• Immune – immune system development may be influenced, affecting the future risk of asthma and allergic diseases¹⁷.
• Cognitive – brain development may be influenced, with potentially long-term effects on cognitive function and behaviour¹⁸.

1. Langley-Evans SC. Nutrition in early life and the programming of adult disease: a review. J Hum Nutr Diet. 2015 28(1):1-14. 
2. Linnér A, Almgren M. Epigenetic programming—The important first 1000 days. Acta Paediatrica. 2020;109:443–452.
3. Barker, D.J. & Osmond, C. (1987) Death rates from stroke in England and Wales predicted from past maternal mortality.BMJ. 295,83–86.
4. Barker D, Osmond C. Infant mortality, childhood nutrition and ischemic heart disease in England and Wales. Lancet. 1986;40:37-44
5. Osmond, C., Barker, D.J. & Slattery, J.M. (1990) Risk of deathfrom cardiovascular disease and chronic bronchitisdetermined by place of birth in England and Wales.J. Epidemiol. Community Health 44, 139–141.
6. Barker, D.J., Osmond, C., Golding, J., Kuh, D. &Wadsworth,M.E. (1989) Growth in utero, blood pressure in childhood and adult life, and mortality from cardiovascular disease.BMJ. 298, 564–567.
7. Barker, D.J.P., Bull, A.R., Osmond, C. & Simmonds, S.J.(1990) Fetal and placental size and risk of hypertension in adult life. BMJ. 301, 259–262.
8. Hales, C.N., Barker, D.J.P., Clark, P.M.S., Cox, L.J., Fall, C.,Osmond, C. & Winter, P.D. (1991) Fetal and infant growthand impaired glucose tolerance at age 64. BMJ. 303,1019–1022
9. Barker, D.J., Hales, C.N., Fall, C.H., Osmond, C., Phipps, K. &Clark, P.M. (1993) Type 2 (non-insulin-dependent) diabetes mellitus, hypertension and hyperlipidaemia (syndrome X):relation to reduced fetal growth. Diabetologia 36,62–67
10. Curhan, G.C., Chertow, G.M., Willett, W.C., Spiegelman, D.,Colditz, G.A., Manson, J.E., Speizer, F.E. &Stampfer, M.J.(1996) Birth weight and adult hypertension and obesity inwomen. Circulation 94, 1310–1315
11. Scaglioni et al. Determinants of children’s eating behavior. Am J Clin 2011;94(6):2006s-2011s
12. Mennella et al. Prenatal and Postnatal Flavor Learning by Human Infants. Pediatrics 2001;107:e88
13. Sullivan SA and Birch LL. Infant dietary experience and acceptance of solid foods. Pediatrics 1994;93(2):271-7
14. Lundy B et al. Food texture preferences in infants versus toddlers. Early Child Dev Care 1998;146:69-85
15. Northstone K et al. The effect of age of introduction to lumpy solids on foods eaten and reported feeding difficulties at 6 and 15 months. J Hum Nutr. Diet 2001;14:43-54
16. Lillycrop KA. Effect of maternal diet on the epigenome: implications for human metabolic disease. Proc Nutr Soc 2011;70(1):64-72.
17. Martin R et al. Early life: gut microbiota and immune development in infancy. Benef Microbes 2010;1(4):367-82.
18. Schlotz W and Phillips DI. Fetal origins of mental health: evidence and mechanisms. Brain BehavImmun 2009;23(7):905-16.