Chapter 12 - Nutritional modulators of preconceptional and perinatal factors for primordial prevention of non-communicable diseases: the role of a millet-based diet rich in functional foods

Abstract

Malnutrition in all its forms includes undernutrition (wasting, stunting, underweight), inadequate vitamins or minerals, overweight, obesity, and resulting diet-related non-communicable diseases (NCDs). It should be emphasized that 1.9 billion adults are overweight or obese, while 462 million are underweight, indicating a double burden of NCDs. One-third of pregnant women and infants have been found to have undernutrition and infections. The increased prevalence of malnutrition is characterized by an increased intake of Western style diets and a decrease in physical activity in association with high consumption of tobacco and alcohol among fathers and mothers. The presence of these risk factors during the preconception period among fathers and mothers has been found to cause increased risk of gestational diabetes and preeclampsia during pregnancy and fetal malnutrition with epigenetic damage to the fetus and increased risk of insulin resistance in the newborn. Western-type diets are characterized by lack of food diversity, a poor nutrient profile, and a high glycemic index with high contents of salt, sugar, and trans fat, which are known to have adverse effects. Increased consumption of such foods during the transition from food scarcity (famine or poverty) to affluence results in the emergence of cardiometabolic diseases (CMDs) and other chronic diseases. Consideration of a millet-based Indo-Mediterranean style diet for nutritional modulation of preconceptional and perinatal factors may be important for health of the fetus and mother and for prevention of cardiovascular diseases and other chronic diseases in later life. Recently, treatment with a millet-based intervention diet (N=60) for 12 weeks was associated with a significant decline in cardiometabolic risk factors, including inflammation in CMDs. Underlying these beneficial effects, all subjects received an 11-fold greater amount of millet-based, whole-grain-rich diet, which increased from mean 21.36±3.8 to 235.20±23.6g/day (P<.0001). Among females (N=33) there was a significant increase in hemoglobin and serum calcium and magnesium, indicating that millet-based diet can also prevent undernutrition. It is possible that a millet-based whole-grain-rich Indo-Mediterranean diet may be advised to fathers and mothers during the preconception period and during pregnancy and to the general population because such diets have been found to cause a significant decline in CMD risk factors as well as undernutrition among subjects with a double burden of diseases. WHO has also accepted a “life-course approach” to be important for achieving the population health goals of the United Nations 2030 Agenda, for Sustainable Development Goals.