|SHANKAR, KARTIK - Arkansas Children'S Nutrition Research Center (ACNC)|
|PIVIK, R - Arkansas Children'S Nutrition Research Center (ACNC)|
|JOHNSON, SUSAN - University Of Colorado|
|VAN OMMEN, BEN - Tno Quality Of Life|
|DEMMER, ELIEKE - National Dairy Council|
|MURRAY, ROBERT - The Ohio State University|
Submitted to: Current Developments in Nutrition
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 11/15/2017
Publication Date: 11/22/2017
Citation: Shankar, K., Pivik, R.T., Johnson, S.L., Van Ommen, B., Demmer, E., Murray, R. 2017. Environmental forces that shape early development: What we know and still need to know. Current Developments in Nutrition. 1(11):S17081. https://doi.org/10.3945/cdn.117.001826.
Interpretive Summary: Adequate nutrition is essential for human development and health, but we are only beginning to appreciate the extent to which dietary factors influence both long-term development and day-to-day functioning, and how these effects may be expressed. Understanding these issues will guide strategies for improving health and behavioral/cognitive function across the life-span, and would be of particular importance for determining nutritional requirements during the formative development taking place in the fetus and during childhood. Evidence of nutrition-associated influences from pre-conception through childhood can be found dispersed across investigations using a variety of measures, e.g., metabolic, brain activity and structure, and behavioral. Furthermore, dietary factors are among environmental variables that have epigenetic effects, i.e., can trigger DNA modulations that modify gene expression and related biobehavioral functions. This realization has provided new insights into how nutrient effects may be mediated, and suggests a more informed interpretation will emerge from evaluating nutrient effects in the context of other relevant environmental factors. These various considerations prompted this review, which explores diverse areas relevant to childhood nutrition with the intent of enhancing awareness of the scope of ongoing research, identifying significant information gaps in this research, and discussing future directions of nutrition research.
Technical Abstract: Understanding health requires more than knowledge of the genome. Environmental factors regulate gene function through epigenetics. Collectively, environmental exposures have been called the "exposome". Caregivers are instrumental in shaping exposures in a child's initial years. Maternal dietary patterns, physical activity, degree of weight gain, and body composition while pregnant, will influence not only fetal growth, but also the infants metabolic response to nutrients and energy. Maternal over- or under-weight, excess caloric intake, nutrient imbalances, glucose dysregulation, and presence of chronic inflammatory states, have been shown to establish risk for many later chronic diseases. During the period from birth to age 3 years, when the infant's metabolic rate is high, and synaptogenesis and myelination of the brain are occurring extremely rapidly, the infant is especially prone to damaging effects from nutrient imbalances. During this same period, the infant transitions from a purely milk-based diet to include a wide variety of foods. The process, timing, quality, and ultimate dietary pattern acquired is a direct outcome of the caregiver-infant feeding relationship, with potentially life long consequences. More research on how meal time interactions shape food acceptance is needed to avoid eating patterns that augment existing disease risk. Traditional clinical trials in nutrition, meant to isolate single factors for study, are inadequate to study the highly-interconnected realm of environment-gene interactions in early life. Novel technologies are being used to gather broad exposure data on disparate populations, employing pioneering statistical approaches and correlations applied specifically to the individual, based on their genetic make-up and unique environmental experiences.