What’s New


What Your Mother Eats in Pregnancy and What You Eat in Infancy can affect Your Life-long Health Profile


Scientists have started to unravel the mechanisms driving powerful programming factors (the good, bad and ugly) in pregnancy and early life that impact on life-long health. A summary report from ‘The Power of Programming’ International Conference organised by the EC-funded EARNEST project to mark the end of this five-year research programme investigating the emerging science of early nutrition programming.


Speakers at the international conference The Power of Programming (Munich 6-8 May) claimed that societies undergoing ‘rapid nutrition transition’ will experience major human, social and economic change – but that the emerging science of ‘metabolic programming’ is beginning to provide clues as to how the impact of such changes may be mitigated or reversed. The EC funded EARNEST project (www.metabolic- programming.org), organisers of the international conference, brought together leading experts to discuss the effect of nutrition and other environmental influences during early life on long- term health outcomes such as obesity, cardiovascular disease, chronic lung disease, behavioural and cognitive problems.


What are these programming factors? Speakers presented evidence about the different parts of the mother and child’s diet that can be regarded as ‘positive programmers’; for example, breast milk ( which could be described as the ‘top’ programming candidate ) not only affects future health via its nutrients but possibly through its non nutrient components too. Another ‘positive programmer’, the Mediterranean or ‘Healthy’ Diet, can protect mothers from early delivery and pre-eclampsia and from postnatal depression, as well as improving the neurodevelopment of their babies, and the IQ of their children when they are five. Exciting


new research allows us to dissect out the top foods in these diets – they include fish and vegetables. So what are the active nutrients? Within fish, it appears to be the long chain fatty acids which are providing the benefits, but currently it does not appear possible to pin down a specific effect of the folates within vegetables. But evidence is also emerging that ‘programming’ could have a negative side. Speakers argued that environmental factors such as maternal smoking, air pollution and endocrine disrupting chemicals can act as ‘negative programmers’, adversely affecting the health of mother and child such as in reproductive capacity and obesity.


How much of your health state can be programmed?


Every part! Speakers at the EARNEST Conference demonstrated that programming is so powerful it can have wide ranging effects on specific body ‘parts’; such as bone, heart, gut and brain as well as on ‘conditions’ such as obesity, diabetes and impaired immune function.


It is a complex picture, however, and whilst a great deal of detailed and specific research has been done, much still requires to be done to unravel the specific effects of the different environmental exposures which could impact on the development of the foetus in the womb and the young infant.


More information about The Power of Programming conference and the EARNEST project research programme and its results available at www.metabolic-programming.org.


Nutrition Action Plan – The Delivery Board issues its final report


The key messages for Ministers spelled out by the Board in their final Report are: • A significant problem of malnutrition still exists – in hospital, care homes and the community


• Whilst a great deal of work has been done since the Nutrition Summit (October 2007) much remains to be done


• The messages around malnutrition need to be communicated to as wide an audience as possible including the public


• Leadership and co-ordination of effort is vital for success


• Investment and research into what works is vital


• More focus is needed on vulnerable people at home as 93 per cent of people with malnutrition are living in their own homes


Chaired by Gordon Lishman, the Delivery Board was made up of representatives from the five committees that led the work of the Board around the agreed five priorities: • Raising awareness of the link between nutrition and good health


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• Ensuring guidance is accessible and appropriate • Encouraging screening for all people using health and social care services


• Encouraging provision and access to relevant training on the importance of nutrition


• Clarifying standards and strengthening inspection and regulation


The Board Report (dated August 2009; issued February 2010) demonstrated that good progress had been made across all five priorities. It recommended that to continue to progress the agenda, the Department of Health should prepare a new Delivery Plan and that the Board should continue to play a role in driving activity with the support of a Government Minister.


Gillian Merron, Minister of State for Public Health, Phil Hope, Minister of State for Care Services and Ann Keen, Parliamentary Under- Secretary of State for Health Services signed off the Government’s response to the Board Report. Whilst welcoming the Report, congratulating all involved in the work that had been achieved,


agreeing that malnutrition was an important and still neglected area of health and promising action in improving communications, in particular, the Ministerial team and Response did not support the recommendation that a new Delivery Plan was required nor that the Delivery Board should continue.


The Ministerial Response stated that: “We believe that action must be part of the programmes underway to improve health and social care services – at a local level, closer to frontline delivery.”


The Response also clearly stated that the CQC would be expected to monitor the performance of all health and social care organisations and raise standards: “The Care Quality Commission registration requirements, which include nutrition, make clear what we expect from all health and social care organisations providing care.” The Delivery Board’s Report and the


Government’s Response can be accessed here: http://www.dh.gov.uk/en/Publicationsands tatistics/Publications/PublicationsPolicyAndGu idance/DH_113115


BAPEN In Touch No.57 May 2010


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