Diet Diary: Malnutrition in younger years marker of disorders later

Besides, birth weight and later weight gain, certain micro-nutrients, proteins, amino acids, vitamin B12, folic acid even in the peri-conceptional stage can regulate metabolic characteristics and increase the risk of adult diseases later.

Post-natal nutrition including breastfeeding, protein intake in the first year of life, infant weight gain are also critical. Breastfeeding appears to have a protective effect.

A hypothesis originated by Barker in 1989 — called “Barker’s Theory” — led to much research in this area. Now, there are a vast number of studies which have documented the relations between foetal and/or later risk of cardiovascular disease. The focus has shifted from simply lifestyle-related westernised diets to study the potential role of pre-natal and early post-natal nutrition. This introduced the concept of the developmental origins of chronic diseases, and therefore, the interest in the early life period.

It may be easy to accept the importance of intra-uterine period if we realise that almost three-fourth of cell divisions are over before we are born, that is to say, a newborn is almost a miniature adult. A new theory called “developmental origins of health and disease” (DOHAD) evolved and is applicable to a number of modern day diseases such as diabetes, hypertension, coronary heart disease and cancer, among others.

In other words, damage suffered early in life leads to permanent impairment and also impacts future generations. This highlights the importance of nutrition, preventive health, education and socio-economic benefits. So, besides the burden of deficiency diseases, malnutrition early in life can become a burden for later years.

This provides a unique “window of opportunity” early in life to improve health in adulthood. In the Indian context, where under-nutrition and over-nutrition co-exist, integrated policies and programmes need to be designed with focus on maternal and child health. In other words, public health policies need to address the life cycle rather than only concentrate on the end stages.

Ishi Khosla is a former senior nutritionist at Escorts. She heads the Centre of Dietary Counselling and also runs a health food store. She feels that for complete well-being, one should integrate physical, mental and spiritual health. According to her: “To be healthy should be the ultimate goal for all.”