Nutritional programming in early life: the role of dietary lipid quality for future health☆

Worldwide, overweight and obesity have increased dramatically, not only in high income countries. Clearly, unhealthy diets and sedentary lifestyle are important drivers of the increased obesity rates, but increasing evidence indicates that the vulnerability for later life non-communicable diseases is set during the first 1000 days, the period from conception until 2 years of age. The growth during this period is faster than during any other period in life. Dietary fats provide energy for growth, but also supply essential fatty acid (FA) precursors for long chain polyunsaturated FA that are building blocks and signals for adipose tissue development. Both epidemiological and experimental data support the notion that specific improvements in dietary fat quality, e.g. specific changes in the fatty acid composition as well as the structural organization of dietary lipids, may reduce the risk of obesity and other adverse outcomes in later life, but clinical evidence is limited and largely inconclusive. We anticipate that effects of such relatively small improvements in nutrient quality may be difficult to measure on the short term and have limited impact in healthy children. However, for children that already experience challenging conditions in the womb and have a higher risk profile based on deviations in birthweight and postnatal growth, the potential protective effects of improved dietary lipid quality in early life could be more substantial. Results from randomized clinical studies testing improved lipid quality concepts will help to develop specific strategies to adapt infant nutrition based on the need with the aim to improve long term outcomes.