母親と小児の栄養学
オープンアクセス

概要

Perinatal nutrition and the developing brain

Enitan Ogundipe

The health and wealth of a nation is dependent on an optimal diet and nutritional status of pregnant women as it lays the cornerstone of both physical and mental development in their children who become the future generation. It has been recognized that poor nutrient intake during pregnancy and lactation adversely affects the health of both the pregnant mother and her baby.Less affluent societies, especially in the developing world are particularly at risk of maternal ‘mis-nutrition’ and infant malnutrition. The negative effect of infant malnutrition on a rapidly developing brain has now become a major concern of the United Nations World Food Programme (UN-WFP). It has been said that “if children under two do not receive sufficient nutrition they will be sentenced to a lifetime of mental and physical limitations. We now have what I call the burden of knowledge and WFP is looking for ways to ensure we prioritize those under twos, the most vulnerable of all in the world” (Josette Shaaron Executive Director’s report to the Board of UN-WFP; June 2010). Unbalanced, mismatched maternal dietary and nutritional choices (‘mis-nutrition’) during pregnancy and lactation can have very significant impact on fetal and neonatal brain development. Human and animal studies have shown that malnutrition has irreversible effects on brain size and function. Approximately 70% of brain development occurs before birth and nearly all the rest while the baby is breast-feeding so during this phase of the child’s life adequate maternal nutrition is mandatory for normal brain development More recently, there has been recognition of the importance of Long Chain Polyunsaturated Fatty Acids (LCPUFAs) such as Arachidonic acid (ArA), an omega-6 fatty acid and Docosahexaenoic acid (DHA), an omega-3 fatty acid obtained mainly from fish oil and other animal sources. These LCPUFAs have been shown to be essential for infant brain growth and development and to also significantly impact on pregnant women’s health. Therefore, our focus in this session will be to explore the impact of these LCPUFAs on the developing brain. The effect of sustenance on mental health in preterm newborn children has been progressively valued. Early postnatal development and supplement consumption have been shown to impact mind development and development with ensuing consequences for neurodevelopment that continue into childhood and adolescence. Nourishment could likewise possibly secure against injury. Irritation and perinatal disease assume a vital job in the pathogenesis of white matter injury, the most widely recognized example of mind injury in preterm newborn children. so, nourishing segments with immunomodulatory or anti-inflammatory impacts may fill as neuroprotective operators. Besides, developing proof backings the presence of microbiome-gut-brain axis. The microbiome is thought to associate with the cerebrum through immunological, endocrine, and neural pathways. Subsequently, nourishing segments that may impact gut microbiota may likewise apply advantageous consequences for the creating mind. What's more, the amino corrosive glutamine has been related with an abatement in irresistible horribleness in preterm babies. During the late second and third trimester of pregnancy, significant procedures of cerebrum development and development occur. Both white and gray matter experience an emotional increment in volume, with the cerebellum and cortical dim issue displaying the most elevated development rates. As the cerebrum develops, cortical folding advances and gyrification turns out to be progressively increasingly complex with progressing gestational age . Besides, this stage is described by a plenitude of quickly creating axons, glial cells, oligodendrocytes, and neurons in the white matter. Between 24–40?wk of growth, pre-oligodendroglial progenitors separate to develop myelin-creating oligodendrocytes, axons create and structure associations, and neurons multiply and relocate to the cerebral cortex and deep nuclear grey matter structures. Incredibly preterm babies are along these lines presented to extra-uterine life in a time of basic mental health, particularly of white issue structures, that render them especially powerless to injury. Thus, white matter injury (WMI) is the most well-known example of mind injury following preterm birth. WMI can either result from periventricular leucomalacia (PVL) or from intraventricular hemorrhage (IVH) and ensuing periventricular hemorrhagic infarction (PVHI), despite the fact that the last two just record for a little extent of white matter sores in present day neonatal medication. The frequency of cystic PVL, the most extreme sort of WMI, has additionally significantly declined over the previous decades. It is currently commonly acknowledged that sufficient nourishment is urgent for cerebrum development and improvement of very preterm babies. Moreover, healthful enhancements have been theorized to give neuroprotective impacts. Despite the fact that sustenance will most likely be unable to defeat all major malicious impacts of outrageous rashness and its results on mental health, nourishing treatments may offer advantages to the creating cerebrum. Explicit nourishing enhancements have been appeared to decrease the rate of postnatal contaminations and NEC and have been doled out immunomodulatory properties. Improved immunological equalization and ensuing diminished aggravation may lessen WMI and may likewise apply gainful consequences for the creating mind through the gut-invulnerable cerebrum pivot. Dietary intercessions are specifically compelling as neuroprotective methodologies since they are viewed as protected, modest, cause hardly any reactions, and can be actualized rather without any problem.