Consequences of malnutrition in early life and strategies to improve maternal and child diets through targeted fortified products

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This supplement brings together papers focusing onthe critical 1000 days of human development frompregnancy until 2 years of age. It is the third in anannual series first published as a Special SupplementoftheFoodandNutritionBulletininJune2009.Dietsof poor nutritional quality during pregnancy, infancyandearlychildhoodleadtonutrientintakes,whichdonot meet requirements.This, combined with frequentinfections during early childhood,results in deficits ingrowth (stunting),limited psychosocial development,increased risk of mortality, and reduced learningcapacity and productivity later in life among thosethat survive. Programmes need to prevent these defi-cits by improving maternal and child nutrient intakein addition to preventing and treating infections.Over the past 3 years, the community of nutritionscientists and researchers, activists and developmentpractitioners committed to an integrated approach tonutrition programming has grown. This communityadvocates for a greater focus on maternal, infant andyoung child nutrition (MIYCN), the application of alifecycle approach to programming and the breakingdown of the barriers between expertise and sectorsthat limit the scale-up of cost-effective programmesthat meet the needs of vulnerable populations on asustainedbasis.ThisMIYCNsupplementcontinuestoreflect and contribute to this movement by providingthe results of leading-edge research to inform techni-cal consensus, programme design, policy and furtherresearch. It discusses the consequences of malnutri-tion in early life and focuses on programme-relatedresearch to improve nutrient intake through breast-feeding, promoting consumption of special formu-lated fortified foods that fill nutrient gaps or enhancethe diets of women and children. It also presentsresearch assessing feeding practices and preferencesof caregivers in relation to child feeding and formu-lated products. An operations research project inChina is described that illustrates how these activitieswerebroughttogetherinanintegratedprogrammetoimprove nutrient intake in young children.Dewey and Begum (2011) set the stage by summa-rizing the prevalence, causes and consequences ofstunting.One-third of children under 5 years of age indeveloping countries are stunted,with many childrenin several regions already stunted at birth. Stuntingrates increase during the first 24 months of life withlittle change thereafter until adolescence, whendelayed maturation and an extended growth periodresult in some compensatory growth (Bosch