Nutrition is vital to health, growth, and development through all stages of life. Poor nutrition causes health problems and can contribute to heart disease, high blood pressure, diabetes, stroke, cancer, and other diseases. NIH recently released a draft of its first-ever Strategic Plan for NIH Nutrition Research to focus efforts in advancing the scientific understanding of interactions between diet, nutritional status, biological processes, and the environment. The strategic plan highlights nutrition research efforts across NIH, including NICHD’s focus on nutrition across the lifespan.
Bridging Gaps in Nutrition Knowledge
Most people know that nutritional needs change with age. However, little is known about specific nutritional needs for each life stage. For example, we know that puberty and pregnancy are times of critical growth and development, but there is limited information on specific nutritional needs before and during pregnancy, and how over- or undernutrition during these periods may affect long-term health of mothers and their offspring.
This lack of knowledge also applies to infancy. Researchers know that nutrition exposure in the womb affects a person’s health into adulthood, but there are few specifics on long-term effects on infant and childhood immune function, endocrine function and metabolism, chronic disease risk, taste and food preferences, mental health, and cognition. The composition and function of human milk, a key component of infant nutrition, is also poorly understood. More research into the first 1,000 days (the time from conception through 24 months) of life would help advance knowledge on the role of nutrition in early childhood development. Research may also help clarify and advance knowledge of food allergies and overall infant health outcomes.
“At NICHD, we are looking at the big picture; we are not just focused on a specific disease or timeframe,” said Andrew Bremer, M.D., Ph.D., chief of the Pediatric Growth and Nutrition Branch. “We want to know how nutrition is relevant to overall maternal, paternal, and child health. We are interested in the role of nutrition from preconception to adulthood, including its impact on a woman and her fetus during pregnancy.”
The nutrition field offers multiple opportunities for research on populations of key interest to NICHD, including those with chronic conditions, intellectual and developmental disabilities, and recovering from injuries. Understanding not only the nutritional needs of pregnant women, fetuses, and infants, but also the effects of too much or too little of things like sugar and salt could provide a roadmap to better health in adolescence and adulthood. More data also are needed about the timing of exposure to different nutrients, especially in the context of allergies, and about how dietary habits may be associated with obesity and chronic disease development in later years, said Dr. Bremer.
Mind Your PEAS and Sprouts
NICHD researchers recently completed a study examining diet and eating habits during pregnancy and how these factors may be linked to eating and weight gain in newborns and young children. The PEAS (Pregnancy Eating Attributes Study) and Sprouts study (which follows the young children of the women in PEAS) are gathering data on the critical nutritional periods of pregnancy through early childhood. One of the key factors, the study found, involves “food reward sensitivity”–sensory pleasure of eating and the extent to which food cravings motivate people to eat.
“The food we eat affects the reward center of the brain,” said Tonja Nansel, Ph.D., a senior investigator in NICHD’s Division of Intramural Population Health Research. “Foods, especially those high in added sugar and fat, stimulate the brain’s reward center much like alcohol and drugs do,” Nansel added. “So, it may be that foods that are so pervasive in our environment affect our brain in a way that makes it really hard to limit how much we eat them.”
Childhood Nutrition and Obesity
NICHD studies have advanced our understanding of childhood obesity and shown that reducing obesity among kids will require different intervention approaches.
Jack A. Yanovski, M.D., chief of NICHD's Section on Growth and Obesity, leads some of these efforts. His research found that a single gene variation may affect the brain’s regulation of appetite and be linked to obesity. Other work from his lab revealed that even short breaks of activity can improve children’s health, including those who are overweight or obese. More recently, his studies have focused on factors that influence loss-of-control eating and how precision medicine may help treat severe obesity in teens.
NICHD researchers are excited about the renewed attention on nutrition not only because it is their research focus, but also because of its importance to overall health and development. As Dr. Bremer noted, the study of nutrition better defines food for health—finding out exactly what the body needs to thrive at different stages of life. A draft of the Strategic Plan for NIH Nutrition Research is currently available for public comment. NIH anticipates that a final version will be shared with the scientific community in March 2019.