Emeritus Professor of Metabolic Physiology, School of Life Sciences, University of Nottingham, Nottingham, UK.
Head of Nestlé Institute of Health Sciences, Nestlé Research, Société des Produits Nestlé S.A., Lausanne, Switzerland.
Nestle Nutr Inst Workshop Ser. 2024;100:1-15. doi: 10.1159/000540138.
Malnutrition is present in most countries of the world. This ranges from general undernutrition due to insufficient food, or poor-quality diets low in some essential nutrients, to overnutrition and obesity with energy-rich but nutrient-poor diets. The fundamental aim of dietary recommendations is to prevent deficiency diseases, and the assumptions which underpin these recommendations need to be understood when considering what advice to give to the general public or individual patients. This is particularly relevant in early life as the nutritional state and dietary intake of the mother are of major importance for both her and her baby's health. There is a particular concern with pregnancy in teenage women, as they are still likely to be growing and have different nutrient requirements compared to older women. There is now evidence of beneficial effects for both the mother and baby of supplementation of the mother's diet in those with a low nutritional status. For infants, early gut microbiome development is supported by human milk components (including oligosaccharides) and the reported health benefits are of growing interest and offer potential areas for future developments. Yet, the increasing overweight and obesity in children are a serious concern, in both developed and developing economies. Considerations of the achievements, challenges, and future directions of early life nutrition need to be addressed in a global environment in which every country in the world is experiencing some form of malnutrition. The term malnutrition encompasses a number of different scenarios ranging from undernutrition, which encompasses an inadequate nutrient intake in a diet with a low level of diversity, up to overnutrition where there is an excess of energy intake in a diet which is predominantly composed of nutrient-poor foods. The major feature of malnutrition is that there is micronutrient inadequacy, and even deficiency, which is particularly concerning in early life. The present chapter will consider the major achievements and future challenges in relation to achieving optimal nutrition in early life as well as in older children. Clearly, when considering nutrition in children, it is important to also consider the nutritional state of women before, during, and after pregnancy, as this can have a major impact on the fetus and young child. Before considering these issues in detail, this chapter will begin by addressing the basis on which nutritional recommendations are founded and the challenges that have to be met in getting novel recommendations approved by the appropriate authorities.
营养不良存在于世界上大多数国家。这种情况范围很广，从由于食物不足或某些必需营养素质量差而导致的普遍营养不足，到营养过剩和肥胖，以及富含能量但营养贫乏的饮食。饮食建议的根本目的是预防营养缺乏症，在考虑向公众或个别患者提供什么建议时，需要了解支撑这些建议的假设。这在生命早期尤为重要，因为母亲的营养状况和饮食摄入对她和她的婴儿的健康都非常重要。青少年女性的怀孕尤其令人关注，因为与年长女性相比，她们仍可能在成长，并且有不同的营养需求。现在有证据表明，对于营养状况不佳的母亲，补充其饮食对母亲和婴儿都有有益的影响。对于婴儿来说，早期肠道微生物群的发展得到了人乳成分（包括低聚糖）的支持，并且所报道的健康益处越来越受到关注，并为未来的发展提供了潜在的领域。然而，儿童超重和肥胖的问题在发达国家和发展中国家都是一个严重的问题。在世界上每个国家都在经历某种形式的营养不良的全球环境中，需要考虑生命早期营养的成就、挑战和未来方向。营养不良这个术语涵盖了许多不同的情况，从营养不足到营养过剩。营养不足包括饮食中营养素摄入不足且种类单一，营养过剩则指的是饮食中富含营养但能量摄入过多。营养不良的主要特征是存在微量营养素不足甚至缺乏，尤其是在生命早期。本章将考虑在生命早期以及较大儿童中实现最佳营养方面的主要成就和未来挑战。显然，在考虑儿童营养时，重要的是还要考虑妇女在怀孕前、怀孕中和怀孕后的营养状况，因为这会对胎儿和幼儿产生重大影响。在详细讨论这些问题之前，本章将首先讨论营养建议的基础以及在获得权威机构批准的新建议时需要克服的挑战。
