Nutrition in Early life Flashcards
What is DOHAD?
DOHAD stands for Developmental Origins of Health and Disease and is an approach that describes the relationship between early human development and health and disease later in life.
What is the Barker hypothesis? And what was it based on?
That fetal in-utero environment is a significant determinant of risk for major chronic diseases. The hypothesis was developed when they saw that poor maternal nutritional environment during pregnancy results in delivery of low birthweight infants. On top of this, these infants showed higher incidence of chronic disease later in life.
It is certain that early life stress (in any form) is associated with chronic diseases later in life. However, there are certain factors that determine the impact of this early life stress. Name these.
- Timing during development
- Sensitivity of the person/organ
- Kind of insult (i.e. stress)
What is meant with the critical-time window?
That, especially during early life, when a fetus or infant is still developing its organs, the body is most sensitive for damage/effects caused by e.g. the environment.
Name factors that cause early life stress.
- Mental causes
- Psychological causes
- Endogenic physical stressors such as maternal illness or child factors (preterm labour or neonatal infections for example)
During normal pregnancy, the brain of the fetus is protected from maternal increases in glucocorticoids by metabolization and inactivation of glucocorticoids by an enzyme (11BHSD2) located in the placenta. However, this mechanism is different in regard to synthetic corticosteroids. Explain what happens when synthetic corticosteroids reach the fetus.
While synthetic corticosteroids are biochemically similar to natural glucocorticoids, the enzyme 11BHSD2 is not always able to recognize and/or correctly metabolize synthethic corticosteroids into inactive compounds. Therefore, synthethic corticosteroids are able to bypass the placenta, where the synthethic corticosteroids can interact with the developing organs of the fetus.
What are risk factors of intrauterine growth retardation (IUGR)?
- Maternal factors, e.g. age, stress, substance (ab)use, under/overnutrition, etc.
- Placental and cord abnormalities, e.g. placental insufficiency (reduced amino acid transport), placental tumour, etc.
- Foetal factors, e.g. developmental disorders such as congenital heart disease, trisomy 21/18/13, etc.
- Infections, e.g. malaria or other virusses
What is the nutritional importance of breastmilk?
Provide building blocks for growth and development, such as hormones, cytokines and maternal mRNA.
What influences the composition of breastmilk?
Gestational age, age of the infant, time of the day, maternal diet, maternal stress.
What is seen in breastmilk regarding adaptation to nutritional needs over time (in weeks)? What is the problem with infant formula here?
That the amount of proteins present in breastmilk decreases over time, whereas the protein level in infant formula stays the same.
What are advantages of breast milk?
- Reduction in infection incidence
- Lower incidence of necrotizing enterocolitis
- Earlier attainment of full enteral feeding/better tolerance
- Lower chances of readmission after neonatal intensive care unit discharge
- Beneficial for brain development
Is obesity genetic?
Yes, this is confirmed by researching obesity in di- and monozygotic twins. Where the monozygotic twins (sharing the same DNA) both have obesity, whereas only one of the dizygotic twins (sharing partly the same DNA) has obesity.
