Early nutrition and its later consequences: new opportunities.

Some 30 years ago Dörner proposed that disease risk and body functions in human adults are programmed during critical early periods of development by hormones and metabolites. Indeed, dietary factors in pregnant and lactating women and in their children were shown to modulate growth and functional development of the organism and to exert life-long programming effects on health, disease and mortality risks in adulthood, neural function and behaviour, and the quality of life. Much of the available evidence on nutritional programming in humans has come from historical observational studies that cannot examine the association with diet directly, establish whether associations are causal, and identify appropriate dietary recommendations for pregnant women and infants. Also, open questions exist on the critical pre- and postnatal time periods during which nutritional exposures programme later health. Therefore, a new approach is required to study early programming of adult health that integrates evidence from randomised controlled trials in humans, prospective observational studies and animal experiments. Considering the far-reaching consequences for public health, policy and product development, major investments in research on early nutritional programming are justified.