Potential Micronutrient Deficiencies in the First 1000 Days of Life: The Pediatrician on the Side of the Weakest

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Abstract

Purpose of Review

This study is to examine potential micronutrient deficiencies and any need for supplementation in children following specific diet plans in the first 1000 days of life.

Recent Findings

Optimal nutrition in the first 1000 days of life has a lifelong positive impact on child development. Specific intrauterine and perinatal factors, pathological conditions, and dietary restrictions can represent potential risk factors for micronutrient deficiencies in the first 1000 days of life, which can have negative systemic consequences. Preterm and low-birth-weight infants are intrinsically at risk because of immature body systems. Children affected by cystic fibrosis are prone to malnutrition because of intestinal malabsorption. The risk of micronutrient deficiency can increase in various situations, including but not limited to children following selective dietary regimens (vegetarian and vegan diets and children affected by specific neuropsychiatric conditions) or specific dietary therapies (children affected by food allergies or specific metabolic disorders and children following restricted diet as a part of therapeutic approach, i.e., ketogenic diet for epilepsy). In light of this situation, the micronutrient status in these categories of children should be investigated in order to tailor strategies specific to the individual’s metabolic needs, with a particular focus on deficiencies which can impair or delay the physical and cognitive development of children, namely, vitamin B12, vitamin D and folic acid, as well as oligo-elements such as iron, zinc, calcium, sodium, magnesium, and phosphorus, and essential fatty acids such as omega-3.

Summary

Identification of micronutrient deficiency in the first 1000 days of life and timely supplementation proves essential to prevent their long-term consequences.

Graphical Abstract

Supplementary Information

The online version contains supplementary material available at 10.1007/s13679-024-00554-3.

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Most cited references 81

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The Epidemiology of Global Micronutrient Deficiencies

Regan L. Bailey, Keith P. West Jr, Robert E Black (2015)

Micronutrients are essential to sustain life and for optimal physiological function. Widespread global micronutrient deficiencies (MNDs) exist, with pregnant women and their children under 5 years at the highest risk. Iron, iodine, folate, vitamin A, and zinc deficiencies are the most widespread MNDs, and all these MNDs are common contributors to poor growth, intellectual impairments, perinatal complications, and increased risk of morbidity and mortality. Iron deficiency is the most common MND worldwide and leads to microcytic anemia, decreased capacity for work, as well as impaired immune and endocrine function. Iodine deficiency disorder is also widespread and results in goiter, mental retardation, or reduced cognitive function. Adequate zinc is necessary for optimal immune function, and deficiency is associated with an increased incidence of diarrhea and acute respiratory infections, major causes of death in those <5 years of age. Folic acid taken in early pregnancy can prevent neural tube defects. Folate is essential for DNA synthesis and repair, and deficiency results in macrocytic anemia. Vitamin A deficiency is the leading cause of blindness worldwide and also impairs immune function and cell differentiation. Single MNDs rarely occur alone; often, multiple MNDs coexist. The long-term consequences of MNDs are not only seen at the individual level but also have deleterious impacts on the economic development and human capital at the country level. Perhaps of greatest concern is the cycle of MNDs that persists over generations and the intergenerational consequences of MNDs that we are only beginning to understand. Prevention of MNDs is critical and traditionally has been accomplished through supplementation, fortification, and food-based approaches including diversification. It is widely accepted that intervention in the first 1,000 days is critical to break the cycle of malnutrition; however, a coordinated, sustainable commitment to scaling up nutrition at the global level is still needed. Understanding the epidemiology of MNDs is critical to understand what intervention strategies will work best under different conditions.

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Position of the Academy of Nutrition and Dietetics: Vegetarian Diets.

Vesanto Melina, Winston Craig, Susan Levin (2016)

It is the position of the Academy of Nutrition and Dietetics that appropriately planned vegetarian, including vegan, diets are healthful, nutritionally adequate, and may provide health benefits for the prevention and treatment of certain diseases. These diets are appropriate for all stages of the life cycle, including pregnancy, lactation, infancy, childhood, adolescence, older adulthood, and for athletes. Plant-based diets are more environmentally sustainable than diets rich in animal products because they use fewer natural resources and are associated with much less environmental damage. Vegetarians and vegans are at reduced risk of certain health conditions, including ischemic heart disease, type 2 diabetes, hypertension, certain types of cancer, and obesity. Low intake of saturated fat and high intakes of vegetables, fruits, whole grains, legumes, soy products, nuts, and seeds (all rich in fiber and phytochemicals) are characteristics of vegetarian and vegan diets that produce lower total and low-density lipoprotein cholesterol levels and better serum glucose control. These factors contribute to reduction of chronic disease. Vegans need reliable sources of vitamin B-12, such as fortified foods or supplements.

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Vegetarian, vegan diets and multiple health outcomes: a systematic review with meta-analysis of observational studies.

Monica Dinu, Rosanna Abbate, Gian Franco Gensini … (2017)

Beneficial effects of vegetarian and vegan diets on health outcomes have been supposed in previous studies.

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Author and article information

Contributors

Luca Pecoraro: luca.pecoraro@aovr.veneto.it

Journal

Journal ID (nlm-ta): Curr Obes Rep

Journal ID (iso-abbrev): Curr Obes Rep

Title: Current Obesity Reports

Publisher: Springer US (New York )

ISSN (Electronic): 2162-4968

Publication date (Electronic): 21 March 2024

Publication date PMC-release: 21 March 2024

Publication date (Print): 2024

Volume: 13

Issue: 2

Pages: 338-351

Affiliations

[1 ]Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, Pediatric Clinic, University of Verona, ( https://ror.org/039bp8j42) P.Le Stefani, 1 – 37126, Verona, Italy

[2 ]Regional Centre for Newborn Screening, Diagnosis and Treatment of Inherited Metabolic Diseases and Congenital Endocrine Diseases, Pediatric Clinic, Azienda Ospedaliera Universitaria Integrata, ( https://ror.org/00sm8k518) Verona, Italy

[3 ]Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, ( https://ror.org/039bp8j42) P.Le Stefani, 1 – 37126, Verona, Italy

[4 ]Pennington Biomedical Research Center, ( https://ror.org/040cnym54) Baton Rouge, LA 70808 USA

Article

Publisher ID: 554

DOI: 10.1007/s13679-024-00554-3

PMC ID: 11150320

PubMed ID: 38512555

SO-VID: 86756426-fe61-4a6f-8f43-242d91a5678e

License:

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

History

Date accepted : 11 February 2024

Funding

Funded by: Università degli Studi di Verona

Open Access :

Open access funding provided by Università degli Studi di Verona within the CRUI-CARE Agreement.

Custom metadata

ScienceOpen disciplines: Health & Social care

Keywords: micronutrients,1000 days,vegetarian diet,exclusion diet,insufficient micronutrients storage,micronutrients adsorption defect

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ScienceOpen disciplines: Health & Social care

Keywords: micronutrients, 1000 days, vegetarian diet, exclusion diet, insufficient micronutrients storage, micronutrients adsorption defect

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Potential Micronutrient Deficiencies in the First 1000 Days of Life: The Pediatrician on the Side of the Weakest

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Abstract

Purpose of Review

Recent Findings

Summary

Graphical Abstract

Supplementary Information

Related collections

Life Sciences by AKJournals

Most cited references 81

The Epidemiology of Global Micronutrient Deficiencies

Position of the Academy of Nutrition and Dietetics: Vegetarian Diets.

Vegetarian, vegan diets and multiple health outcomes: a systematic review with meta-analysis of observational studies.

Author and article information

Contributors

Journal

Affiliations

Article

History

Funding

Categories

Custom metadata

Comments

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