The First 1,000 Days of Life Count: How Micronutrients Impact a Child's Ability to Grow and Learn

By Manfred Eggersdorfer and Barbara Troesch

The quality of nutrition during the first 1,000 days - the period between conception and the child’s second birthday – are crucial for health and development along the life cycle. However, malnutrition remains a leading cause of death and illness in young children and those with adequate nutrition are 10 times more likely to overcome common diseases of childhood [1, 2]. Nutrient deficiencies during pregnancy are associated with preterm birth, neural tube defects and low birth weight [3, 4] and such impaired development early in life has far reaching consequences such as lower school attainment and earned wages (in men) as well as increased poverty risk [5]. Moreover, poor nutrition during early life is thought to have long term consequences like coronary heart disease, hypertension and diabetes in the adult years [6]. An important scientific development in this field was Dr. Bruce Ames’ pioneering triage theory, which states that the body prioritizes the use of micronutrients when they are scarce and that priority is given to functions that ensure short-term survival and reproduction at the expense of long-term health [7, 8]. 

The role of multi-vitamins and omega-3s

Novel scientific findings show that women receiving multi-vitamins plus iron and folic acid have reduced risk for stillbirth [9], and emerging evidence suggests that maternal multi-micronutrient supplementation may lead to healthier gestation and reduce the risk of preterm birth and low birth weight particularly in low income countries [10]. Research continues to highlight the important role that omega-3 fatty acids play for both mother and baby [11, 12, 13]. Docosahexaenoic acid (DHA) in particular has been shown to support a healthy pregnancy [11, 12]. It is also recognized to be important for optimal foetal and infant growth; with an important role in brain, eye and nervous system development and function. An expert group reviewing more recent scientific evidence reported the possible beneficial effects of DHA on later child visual and cognitive and emotional development. Moreover that “The LC-PUFA supply and fish intake in pregnancy and infancy seem to positively affect the development of immune responses involved in allergic reactions, and reduce the risk of allergic diseases (asthma and eczema) [13].

Healthy diet, healthy mother, healthy child

Even though a varied, nutrient dense diet can provide most nutrients in the amounts needed during pregnancy, a large majority of the population does not meet dietary recommendations. While a significant number of adults in the U.S. did not consume the recommended amounts of nutrient-rich foods, they tended to consume too much of the foods that should rather be avoided such as solid fats, sugars and alcoholic beverages [14]. Poor dietary choices seem to be a global problem as a recent study reported low intakes of fruits and vegetables for 58% to 88% adults across all geographic clusters [15].Consequently, micronutrient deficiencies during pregnancy are still a global public health concern. For example, the estimated global prevalence of prenatal iron deficiency is 15–20% [16]. Vitamin A deficiency affects an estimated 15% of pregnant women in low-income countries, while in 8% it is severe enough to cause to night blindness [17]. Iodine deficiency ranges from 17% in Oceania to 40% in Africa [1]. A review of diets among pregnant women in high-income countries found intakes of folate, iron and vitamin D to be below recommended intakes [18]. A significant number of pregnant women do not reach recommendations for DHA and the addition of supplements to the diet increases the likelihood of adequate intakes [19].

In conclusion, healthcare professionals should recommend three simple steps to healthy nutrition during pregnancy: adopting a balanced diet, consuming fortified foods and supplementing the diet with minerals, vitamins and omega-3 fatty acids.

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