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La nutrition des mille premiers jours : quels enjeux ?

Abstract : Supplying the 'raw materials' required to sustain growth and neurodevelopment has long been considered the sole role of nutrition in the first 1000 days of life. Towards the end of the 20th century, evidence from epidemiologist David Barker revealed that nutrition received in early life has another, possibly more important role, as it may 'program' the risk of developing chronic disease in later adulthood. In utero undernutrition, through impaired fetal amino acid availability, results in intrauterine growth restriction (IUGR), which increases not only perinatal morbi-mortality, but the risk of developing obesity, hypertension, type 2 diabetes, and coronary insufficiency in the future adult. Such evidence led to the emergence of the concept of the developmental origins of health and disease (DOHaD). Its mechanisms, though incompletely understood, likely involve alterations in the growth of specific developing tissues, epigenetic modifications, fetal overexposure to cortisol, the transmission of altered microbiota from mother to child, or the effect of growth trajectory per se. After birth, undernutrition commonly occurs in preterm infants, and results in extra-uterine growth restriction (EUGR), followed by catch-up growth, which may have deleterious long-term effects on adult health. Even before the mechanisms of 'nutritional programming' are fully understood, simple nutritional strategies of prevention exist, and include the optimization of nutrition in pregnancy, intensifying nutrition of preterm infants in neonatology units, and the promotion of breastfeeding. (C) 2020 Societe francophone nutrition clinique et metabolisme (SFNCM).
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https://hal.inrae.fr/hal-03209178
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Submitted on : Tuesday, April 27, 2021 - 9:38:57 AM
Last modification on : Wednesday, April 28, 2021 - 3:15:22 AM

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Dominique Darmaun. La nutrition des mille premiers jours : quels enjeux ?. Nutrition Clinique et Métabolisme, Elsevier Masson, 2020, 34 (3), pp.183-193. ⟨10.1016/j.nupar.2020.04.004⟩. ⟨hal-03209178⟩

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