Improving nutrition throughout the life course

Fact sheet
17 March 2012

The Health and nutritional status of mothers before and during pregnancy affects the growth and development potential (e.g. learning and mental development) of their babies. Undernutrition during pregnancy increases the risk of intrauterine growth retardation in babies which will increase children’s risk of obesity and of developing noncommunicable diseases (NCD), such as cardiovascular diseases and type 2 diabetes later in life. Taking a life course perspective, therefore, has great potential for improving the health and nutritional well-being of the population.

Key interventions during various stages of the life course include:

Pre-pregnancy

Women of reproductive age should have a balanced diet to ensure good nutritional status prior to conception. In settings where the prevalence of anaemia among women of reproductive age is 20% or higher, intermittent iron and folic acid supplementation is recommended as a public health intervention in menstruating women, to improve haemoglobin concentrations, iron status and reduce anaemia.

Pregnancy

A balanced diet is important for adequate nutrition to address common nutrient deficiencies among pregnant women that include iodine, iron, vitamin A and zinc. Deficiency of iodine causes retarded foetal brain development. Iodized salt should be taken to prevent iodine deficiency. If iodized salt is not available, iodine supplements should be administered.

Deficiency of iron causes anaemia, which increases the risk of maternal mortality, foetal growth retardation, and prenatal mortality. Intermittent iron and folic acid supplementation is recommended in non-anaemic pregnant women to prevent development of anaemia and to improve gestational outcomes. Routine daily oral iron and folic acid supplementation is recommended in pregnant women to reduce the risk of having a low-birth-weight baby and maternal anaemia and iron deficiency at term.

Deficiency of vitamin A leads to poor reproductive health, slow growth and development. Pregnant women should consume foods high in beta-carotene and vitamin A, such as red, orange and yellow fruits and vegetables. In areas where vitamin A deficiency is a severe public health problem, vitamin A supplementation in pregnancy is recommended for the prevention of night blindness.

0-6 months

An infant should be exclusively breastfed for the first six months , which should be initiated within the first hour after birth.

Exclusive breastfeeding, meaning no additional food or drink, meets all energy and nutrient requirements of the baby, and promotes optimal cognitive and sensory development. It also protects babies from diseases caused by unclean food and water. A child’s growth should be monitored from birth to help determine if interventions are required. The WHO Child Growth Standards, based on the growth path of exclusively breastfed children, are referred to as normative growth standard and should be used to monitor the child’s growth.

Other interventions that will help babies develop immunity include delayed clamping of the umbilical cord, immediate drying of the baby, immediate skin to skin contact with the mother, and a delayed bath (six hours after birth).

6-23 months

Energy-and nutrients-appropriate safe complementary foods should be introduced at six months. Breastfeeding, still a major source of nutrients for infants, should be continued until 2 years and beyond. Home fortification of foods with micronutrient powders containing at least iron, vitamin A and zinc is recommended to improve iron status and reduce anaemia among infants and children 6–23 months of age. Growth monitoring should be continued to track the child’s developmental path.

Pre-school age (2-5 years)

At preschool age, children should be provided with an adequate diet. In settings where the prevalence of anaemia in preschool or school-age children is 20% or higher, intermittent use of iron supplements is recommended as a public health intervention to prevent anaemia and improve the iron status among these children. In settings where vitamin A deficiency is a public health problem, vitamin A supplementation is recommended in infants and children 6–59 months of age as a public health intervention to reduce child morbidity and mortality Children should be dewormed 2-3 times a year to eliminate worm infections that may reduce their capacity to absorb necessary nutrients and exacerbate undernutrition. Growth monitoring should be continued, to track the child’s developmental path

School age (5-10~12 years)

Balanced diets should be promoted to ensure that the nutritional needs of school-age are met, for a healthy growth. School feeding programmes may help to achieve this. In settings where the prevalence of anaemia in preschool or school-age children is 20% or higher, intermittent use of iron supplements is recommended as a public health intervention to prevent anaemia and improve the iron status among these children. Deworming may still be necessary in this age group.

Nutrition education should be built into school curricula to enhance students’ knowledge of nutrition, healthy diet and physical activity. Pre-schools and schools offer many opportunities to promote healthy dietary and physical activity patterns for children and are also a potential access point for engaging parents and community members in preventing child malnutrition in all its forms (i.e. undernutrition, micronutrient deficiencies, and obesity and nutrition-related noncommunicable disease). Encouraging children to tend a vegetable garden at school is a useful way to provide nutrition education to children

Adolescence (10-12-18 years)

Nutrient requirements increase during the adolescent years due to an accelerated rate of growth. A balanced diet is crucial at this stage.

Nutrition education should be continued in school curriculum. In settings where the prevalence of anaemia among women of reproductive age is 20% or higher, intermittent iron and folic acid supplementation is recommended as a public health intervention in menstruating women, to improve haemoglobin concentrations, iron status and reduce anaemia.

Improving the nutritional status of school-age children is an effective investment for:

  • improving educational outcomes of school children
  • establishing healthy dietary and physical activity patterns among young people thereby promoting health and nutritional well-being and preventing obesity and various noncommunicable diseases, and
  • improving nutrition among adolescent girls – considered in a life course perspective, this will benefit the health and nutrition of the next generation.

Adults

It is important to maintain a robust immune system in adulthood. Adults should engage in adequate physical activities and consume a balanced diet to maintain a healthy and active lifestyle. This is essential for preventing various diet-related noncommunicable diseases such as diabetes, hypertension, and cardiovascular diseases.

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