More evidence for the importance of early life nutritional status on child health outcomes

Abstract

A concept that continues to gain ground is that the in utero environment—including maternal health, nutritional status, diet, environmental exposures to medications, toxins, and more—can have an important influence on long-term health outcomes. Supported by numerous epidemiologic, clinical, and biological observations, the Developmental Origins of Health and Disease is a field of discovery that promises to shed new light on disease prevention and health promotion. The report in this volume of The Journal by Abera et al adds another important data point that underscores the importance of fetal growth and nutritional status on longer term health, in this case early childhood mental health. Using data from a well-characterized Ethiopian birth cohort study, the investigators examined the relationship between nutritional status (primarily body composition and growth status) in early infancy on one hand, and child mental health (a parent-reported brief behavioral screening questionnaire) on the other. The main findings were that fetal accretion of fat-free mass (as determined by body composition at birth) was associated with better child behavior scores at 5 years of age, as compared with fetal accretion of fat mass. Interestingly, there was no significant relationship between body composition at age 5 and behavior reports, further emphasizing the critical timing of in utero influences. Similar data that linked fat-free mass with neurologic outcomes at 2 years of age have also been recently reported (J Pediatr 2018;196:301-4). We look forward to continued follow-up of this well characterized cohort to evaluate longer term outcomes, as well as to more evidence along the Developmental Origins pathway in other settings. Article page 225 ▶ Body Composition during Early Infancy and Mental Health Outcomes at 5 Years of Age: A Prospective Cohort Study of Ethiopian ChildrenThe Journal of PediatricsVol. 200PreviewTo examine the relationship between body composition—specifically fat mass (FM) and fat-free mass (FFM)—in early infancy, and mental health outcomes in early childhood. Full-Text PDF