Abstract
Experimental evidence from animal models and epidemiology studies has demonstrated that nutrition affects lung development and may have a lifelong impact on respiratory health. Chronic restriction of nutrients and/or oxygen during pregnancy causes structural changes in the airways and parenchyma that may result in abnormal lung function, which is tracked throughout life. Inadequate nutritional management in very premature infants hampers lung growth and may be a contributing factor in the pathogenesis of bronchopulmonary dysplasia. Recent evidence seems to indicate that infant and childhood malnutrition does not determine lung function impairment even in the presence of reduced lung size due to delayed body growth. This review will focus on the effects of malnutrition occurring at critical time periods such as pregnancy, early life, and childhood, on lung growth and long-term lung function.
Highlights
Lung development is a multistage and multilevel process sustained by biochemical, mechanical and anatomical events spanning all gestational ages, from the end of the third week post-conception onwards, and continuing into post-natal life until around 22 years of age [1,2]
Placental insufficiency generally occurs in the second half of pregnancy, at the time of acinar and alveolar development, the distal lung is most likely to be affected by Intrauterine growth restriction (IUGR) [11,12,13]
With regard to the effects of vitamin A supplementation on lung development, in animal models with prenatal vitamin A-deficiency, subsequent treatment with retinoic acid reversed some of the structural alterations that had been induced by missing retinol activity [119,120]
Summary
Lung development is a multistage and multilevel process sustained by biochemical, mechanical and anatomical events spanning all gestational ages, from the end of the third week post-conception onwards, and continuing into post-natal life until around 22 years of age [1,2]. Nutrition has a key role in prenatal lung development, directly affecting mechanisms of lung growth and influencing developmental programming through epigenetic changes [7,8]. The influence of nutrition on lung growth continues in post-natal life, especially in early infancy [9]. Intrauterine growth restriction (IUGR) is the most common effect of chronic impaired prenatal nutrition, mostly (80–90%) due to reduced flow of nutrients and oxygen to the fetus through the placenta because of either placental insufficiency or maternal dietary deficiencies [10]. This review will examine the effects of impaired nutrition and micronutrients deficit occurring during pregnancy, early life and childhood, on lung growth and respiratory health. Epidemiology aspects and pathophysiology mechanisms of the relationship between nutrition and the respiratory system will be discussed
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