Department of Community Health Sciences, UCLA Fielding School of Public Health, Los Angeles, CA, USA,
Matern Child Health J. 2014 Feb;18(2):450-61. doi: 10.1007/s10995-013-1280-3.
The "Life Course Perspective" proposes that environmental exposures, including biological, physical, social, and behavioral factors, as well as life experiences, throughout the entire life span, influence health outcomes in current and future generations. Nutrition, from preconception to adulthood, encompasses all of these factors and has the potential to positively or negatively shape the individual or population health trajectories and their intergenerational differences. This paper applies the T2E2 model (timing, timeline, equity and environment), developed by Fine and Kotelchuck, as an overlay to examine advances in nutritional science, as well as the complex associations between life stages, nutrients, nutrigenomics, and access to healthy foods, that support the life course perspective. Examples of the application of nutrition to each of the four constructs are provided, as well as a strong recommendation for inclusion of nutrition as a key focal point for all health professionals as they address solutions to optimize health outcomes, both domestically and internationally. The science of nutrition provides strong evidence to support the concepts of the life course perspective. These findings lend urgency to the need to improve population health across the life span and over generations by ensuring ready access to micronutrient-dense foods, opportunities to balance energy intake with adequate physical activity and the need for biological, social, physical, and macro-level environments that support critical phases of human development. Recommendations for the application of the life course perspective, with a focus on the emerging knowledge of nutritional science, are offered in an effort to improve current maternal and child health programs, policies, and service delivery.
“生命历程观”提出，环境暴露因素，包括生物、物理、社会和行为因素以及整个生命周期中的生活经历，会影响当前和后代的健康结果。营养从受孕前到成年期涵盖了所有这些因素，并有可能积极或消极地塑造个体或人群的健康轨迹及其代际差异。本文应用 Fine 和 Kotelchuck 开发的 T2E2 模型（时间、时间线、公平和环境）作为覆盖层，以检查营养科学的进展，以及生命阶段、营养素、营养基因组学和获得健康食品之间的复杂关联，这些关联支持生命历程观。本文提供了营养在这四个结构中的每一个的应用实例，并强烈建议所有健康专业人员将营养作为解决办法的重点，以优化国内外的健康结果。营养科学提供了强有力的证据来支持生命历程观的概念。这些发现迫切需要通过确保人们能够方便地获得富含微量营养素的食物、平衡能量摄入和充足的体育活动的机会，以及支持人类发展关键阶段的生物、社会、物理和宏观环境，来改善整个生命周期和代际的人口健康。本文提出了应用生命历程观的建议，重点是营养科学的新出现的知识，以努力改善当前的母婴健康计划、政策和服务提供。
