Global impact of programming

Nutrition throughout the life course has great significance not only for women and children but also for the health and wellbeing of society. The role of pre-and pregnancy nutritional status can no longer be ignored since it impacts not only conception, gestation, growth and development of the fetus and infant but it also has short and long term consequences on health and disease patterns and economic productivity at later stages of life. Nutrition marks structurally and/or functionally the development of the fetus with lifelong impacts. The magnitude, timing and duration of the nutritional insults define the final impacts; patterns of gene expression and epigenetic changes affect transcription factors controlling multiple target genes thus explaining the consequences on human and economic development. Optimization of environmental conditions affecting early growth should lead to effective approaches to optimize fetal growth to achieve not only an adequate birth-weight but also maximize lifelong health preventing adult disease and disability. Malnourished populations are also more vulnerable to infections and poor length growth affecting brain development and cognitive performance. Labor productivity and income will be lower than that observed in well nourished peers. Poverty will only be broken by actions to improve early nutrition and linear growth. Malnutrition in early life is no longer a health or an ethical-social dilemma but the cause of self perpetuating constraints on economic development. Thus, the impact of early programming has major human-socio-economic implications for all countries, especially societies undergoing a rapid nutrition transition.