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健康与疾病的发育起源(DOHaD)假说如何有助于改善发展中国家的健康状况?

How can the Developmental Origins of Health and Disease (DOHaD) hypothesis contribute to improving health in developing countries?

机构信息

Instituto de Nutrición y Tecnología de Alimentos, Universidad de Chile, Santiago, Chile.

出版信息

Am J Clin Nutr. 2011 Dec;94(6 Suppl):1759S-1764S. doi: 10.3945/ajcn.110.000562. Epub 2011 May 4.

Abstract

The relevance of nutrition during pregnancy and early infancy in defining short-term health and survival has been well established. However, the Developmental Origins of Health and Disease (DOHaD) paradigm provides a framework to assess the effect of early nutrition and growth on long-term health. This body of literature shows that early nutrition has significant consequences on later health and well-being. In this article, we briefly present the main consequences of malnutrition that affect human growth and development and consider how the DOHaD paradigm, with its evolutionary implications, might contribute to better addressing the challenge of improving nutrition. We examine how this paradigm is particularly appropriate in understanding the health and nutrition transition in countries that face the double burden of nutrition-related diseases (acute malnutrition coexisting with obesity and other chronic diseases). We focus on stunting (low height-for-age) to examine the short- as well as long-term consequences of early malnutrition with a life-course, transgenerational, and multidisciplinary perspective. We present current global and regional prevalence of stunting and discuss the need to reposition maternal and infant nutrition not only in health and nutrition intervention programs but also in consideration of the emerging research questions that should be resolved to better orient program and policy decisions.

摘要

孕期和婴儿早期的营养与短期健康和生存的相关性已得到充分证实。然而,健康与疾病的发育起源(DOHaD)概念框架提供了一个评估早期营养和生长对长期健康影响的框架。这方面的文献表明,早期营养对后期的健康和幸福有重大影响。本文简要介绍了影响人类生长发育的营养不良的主要后果,并考虑了 DOHaD 概念框架及其进化意义如何有助于更好地应对改善营养的挑战。我们探讨了这一概念框架如何特别适用于理解面临营养相关疾病双重负担(急性营养不良与肥胖和其他慢性病共存)的国家的健康和营养转型。我们关注发育迟缓(身高低于年龄),从生命过程、跨代和多学科的角度来研究早期营养不良的短期和长期后果。我们展示了当前全球和区域发育迟缓的流行情况,并讨论了不仅在健康和营养干预计划中,而且在考虑应该解决以更好地指导计划和政策决策的新出现的研究问题时,重新定位母婴营养的必要性。

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