Dr von Hauner Children's Hospital, Ludwig-Maximilians-University, Munich, Germany.
Proc Nutr Soc. 2012 Aug;71(3):371-8. doi: 10.1017/S0029665112000596. Epub 2012 Jun 18.
Increasing evidence from the EU Project EARNEST and many other investigators demonstrates that early nutrition and lifestyle have long-term effects on later health and the risk of common non-communicable diseases (known as 'developmental programming'). Because of the increasing public health importance and the transgenerational nature of the problem, obesity and associated disorders are the focus of the new EU funded project 'EarlyNutrition'. Currently, three key hypotheses have been defined: the fuel mediated 'in utero' hypothesis suggests that intrauterine exposure to an excess of fuels, most notably glucose, causes permanent changes of the fetus that lead to obesity in postnatal life; the accelerated postnatal weight gain hypothesis proposes an association between rapid weight gain in infancy and an increased risk of later obesity and adverse outcomes; and the mismatch hypothesis suggests that experiencing a developmental 'mismatch' between a sub-optimal perinatal and an obesogenic childhood environment is related to a particular predisposition to obesity and corresponding co-morbidities. Using existing cohort studies, ongoing and novel intervention studies and a basic science programme to investigate those key hypotheses, project EarlyNutrition will provide the scientific foundations for evidence-based recommendations for optimal nutrition considering long-term health outcomes, with a focus on obesity and related disorders. Scientific and technical expertise in placental biology, epigenetics and metabolomics will provide understanding at the cellular and molecular level of the relationships between early life nutritional status and the risk of later adiposity. This will help refine strategies for intervention in early life to prevent obesity.
越来越多来自欧盟 EARNEST 项目和其他许多研究人员的证据表明,早期的营养和生活方式对以后的健康和常见非传染性疾病(称为“发育编程”)的风险有长期影响。由于肥胖及其相关疾病的公共卫生重要性日益增加且具有跨代性质,因此成为了新的欧盟资助项目“早期营养”的关注焦点。目前,已经确定了三个关键假设:燃料介导的“宫内”假设表明,胎儿在子宫内暴露于过多的燃料,尤其是葡萄糖,会导致胎儿发生永久性变化,从而导致出生后肥胖;加速的产后体重增加假设提出了婴儿期体重快速增加与以后肥胖和不良后果风险增加之间的关联;以及不匹配假设表明,在围产期和肥胖儿童环境之间经历发育“不匹配”与肥胖和相应合并症的特定易感性有关。通过使用现有队列研究、正在进行的新干预研究和基础科学计划来研究这些关键假设,项目 EarlyNutrition 将为考虑长期健康结果的最佳营养提供循证建议的科学基础,重点是肥胖及其相关疾病。胎盘生物学、表观遗传学和代谢组学方面的科学和技术专长将为了解早期生活营养状况与以后肥胖风险之间的关系提供细胞和分子水平的理解。这将有助于完善在生命早期进行干预以预防肥胖的策略。